STOMATOGNATHIC SYSTEM.pptx

8/20/2019 STOMATOGNATHIC SYSTEM.pptx

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SYSTEM

SURYA KRISHNANI MDS



CONTENTS :Introduction

DefnitionFeatures

Jaw

MusclesFunctional o!eent o" Mandi#le

TMJ

Ton$ueFunctions o" stoato$nat%ic s&ste

Conclusion

'e"erance



Introduction : T%e Descri(tion o" t%e (arts t%at a)e u( t%e

Dento"acial Co(le*+t%eir intiate relations wit% eac%

ot%er and t%eir role in t%e acco(lis%ent o" t%e o!erall(attern are onl& t%e (art o" t%e stor&,

T%e Static Anal&sis+ is i(otant+ #ut e-uall& i(ortant isa d&naic a((reciation o" %ow t%ese (arts "unction,

An Ort%odontist can esta#lis% a (er"ect occlusal relations%i( o" t%e teet% +#ut unless %e ta)es into considerationt%e e.ects o" t%e use o" t%ese teet%+a)es allowances"or t%e ani"old en!ironental "unctional in/uences+ t%edelicate #on& structures alon$ wit% t%e teet% (ositionsare su#0ected to c%an$e,

It is #ecoin$ increasin$l& a((arent t%at "unction canin/uence t%e o!erall (attern and t%e relations%i(s o"t%ese (arts+ t%e !er& "oundation o" t%e stoato$nat%ics&ste,



DEFINITION:



Contents o" t%e stoato$nat%ics&ste

Jaw Teet%

Ton$ue

Musculature

Jaw 1 2((er 3 4ower Jaw 56one7 are t%e a0or (art

o" t%e s&ste,

Teet% 18 Arran$ed in t%e u((er 3 4ower 0aw,

8Su((orted #& t%e Al!eolar #one 39eriodontiu,

8Mastication 3 9%onation,

Ton$ue 1 8Hi$%l& Muscular 3 Ada(ti!e Or$an,

8Made o" Intrinsic 3 e*trinsic uscles,



Jaw 1 6ONE COM9ONENT,

6ones "or t%e #asic co(onentstructure o" t%e stoato$nat%ic s&ste,

T%ree ain #ones a)e u( t%e s)eletal

(ortion o" t%e stoato$nat%ic s&ste,MAI44A

MANDI64E

9O'TION OF THE TEM9O'A4 6ONE OF THE S;244,

Ma*illa 3 Mandi#le are t%e #ones t%at%old t%e teet%,Te(oral #one is t%e site

o" t%e Mandi#le Articulation wit% t%e s)ull,



wol"F<s 4aw=

In >?@ +Julius Bol. 14aw o"trans"oration o" 6one,

He attri#uted t%e tra#ecular (attern o"#one +ainl& due to "unctional "orces,

A c%an$e in t%e Direction 3a$nitude o" Force could 9roduce aar)ed c%an$e in t%e Internal

Arc%itecture and E*ternal "or o" t%e#one,

Increase in Function leads to Increase

in t%e Densit& o" 6one,



4aw o" ort%o$nalit&=It is also e*(ressed #& a ec%anical

at%eatical law 1 4aw o" Ort%o$nalit&,

It states t%at #one eleents once "oredrearran$e t%esel!es in t%e direction o" t%e"unctional (ressure and increase or decreaset%eir ass to re/ect t%eir F2NCTIONA4

ST'ESS,It is now esta#lis%ed t%at cartila$inous and

e#raneous #ones react di.erentl& to"orces,

Muscles %a!e a $reat in/uence o!er #ones anda& e!en c%an$e t%e s%a(e,

T%us t%e tied ani(ulation o" t%eusculature a&#e #enefcial to t%e

Ort%odontist,





Tra0ectorial t%eories o" #one"oration=

Me&er 3 Culann5>?@7 6ennin$%o. 5stress

tra0ectories7, Julius Bol. 5>?@7,Mel!in Moss 5Functionalatri* %&(ot%esis7,



6ennin$%o. T%e Tra0ectorial t%eor& states t%at t%e lines o"

Orientation o" #on& Tra#aculae "ollow t%e(at%wa&s o" a*ial (ressure 3 tension,t%esein!ol!e #ot% cancellous as well as Co(act#one,T%ese res(ond to t%e deands o"

Functional Forces collecti!el& as a unit and notas a sin$le #one,

T%e& e*ist not as a ani"estations o" intrinsic$enetic (otential+ #ut direct res(onse to

e(i$enitic 3 local "unctional in/uences,

Head is ade o" two "unctional unit:

Cranio"acial unit

Mandi#le



Ma*illar& Tra0ectories are:

ertical 1 Canine+ &$oatic

6uttress+ 9tr&$oa*illar&,Horiontal 1 Hard 9alate+ Or#ital

/oor+4esser win$ o" s(%enoid #one,



F2NCTIONA4 MAT'IHY9OTHESIS=

9ro(osed #& Mel!in Moss

Descri#es t%e #one $rowt% wit%in t%e cranio"acial

s)eleton as #ein$ in/uenced (riaril& #& Function,5Moss 3 Salenti0in+ >7Growt% o" s)ull is not$eneticall& deterined,

Moss su$$ested t%e Functional cranial co(onent

1Head Functional Matri* 3 S)eletal 2nit,Functional Matri* 1 All tissues+ or$ans 3 s(aces

t%at (er"or a $i!en "unction,

S)eletal unit 1 6ones+ cartila$es 3 tendons t%atsu((ort t%is "unction,Furt%ur di!ided intoMicros)eletal unit 3 Macros)eletal unit



6one "orationK Me&er 3 Culann 1

Tra0ectories were seen crossin$ at ri$%t an$lesto eac% ot%er+ena#lin$ #one to resist t%e"unctional stresses it is su#0ected to,T%eali$nent o" t%e #on& tra#aculae "ollowed adefnite en$ineerin$ (rinci(les,



C4INICA4 Si$nifcance=,

Correction o" Ma*illo andi#ular

de"orities



MANDI64E=

The mandible forms the lower part of ourface. It is suspended from the skull by

muscles, ligaments and soft tissues, and

doesn’t itself attach bone-to-bone to themaxilla, but hangs in space.

U-shaped bone, contains mandibular teeth in

alveolar process.

a!or structural parts- condyle, coronoid

process, ramus, angle, alveolar process,

mental protuberance





MAI44A,, "omposes most of

upper part of face #contains maxillary

teeth.

$used to skull #hence non-mobile.

a!or intra-oral parts-

alveolar process,

palatal process,

incisive foramen,

mid-palatal suture,

maxillary tuberosity.



M2SC4ESMuscle f#res $rou(ed into otor

units,Motor unit L Grou( o" uscle f#res

inner!ated #& one Motor Neuron,Functional unit o" Muscles LNu#er o" uscle f#res (erneuron+ !aries accordin$ to "unction

o" uscles,More f#res L Greater "orce o"o!eent,



E-uili#riu t%eor&

An o#0ect su#0ected to une-ual "orces will#e accelerated and t%ere#& will o!e todi.erent (osition in s(ace,it "ollows t%at i"an& o#0ect is su#0ected to a set o" "orce #ut

reains in t%e sae (osition t%ose "orcesust #e in e-uili#riu,

T%e Dentition is in e-uili#riu since t%eteet% are su#0ected to !ariet& o" "orces #ut

don<t o!e to a new location under usualcircustnces,

T%e duration o" Forces is ore i(ortantt%an its a$nitude due to it<s 6iolo$ical

e.ect,



Muscles o" Mastication,,

9riar& "unctional uscles,9er"orin$ Ma0orit& o" Mandi#ular

o!eents,

Su(ra%&oid Grou( 1 out%o(enin$,

In"ra %&oid Grou( K coordinate

Mandi#ular "unctions,Masseter+ Te(oralis+ Medial

9ter&$oid+ 4ateral 9ter&$oid+

H&oid+ Au*iliar& oral uscles,



MASSETE',,

Su(erfcial (ortion:

Ori$in 1 Anterior rdo" &$oatic arc%,

Insertion 1 Coronoid9rocess+ 'aus+ An$le

o" t%e Mandi#le,Function 1 9ower"ul

Ele!ator,

DEE9 9O'TION:

Ori$in : Medial sur"aceo" &$oatic arc%

Insertion 1 Sae,

Function 1 Ele!ation 3

9rotrusion,



Medial 9ter&$oid=

Ori$in : Medial sur"ace o" 4ateral9ter&$oid 9late,

Insertion : Medial sur"ace o"An$le o" Mandi#le,

Function : Ele!ation 3 9rotrusion,



Te(oralisAnterior 9art:

Ori$in 1 Anterior Te(oral"ossa,

Insertion 1 Coronoid 9rocess,

Function K Ele!ation,

Middle 9art :

Ori$in 1 Middle Te(oral Fossa,

Insertion K Coronoid 9rocess,

Function 1 Ele!ation 3'etraction,

9osterior 9art :Ori$in1 9osterior Te(oral

"ossa,

Insertion 1 Coronoid "ossa,

Function 1 'etrusion,



4ateral 9ter&$oidINFerior Head:

Ori$in : 4ateral sur"ace o" 4ateral 9ter&$oid 9late,

Insertion :Nec) o" Cond&le, Function : 9rotrusion,

Su(erior Head :

Ori$in 1In"rate(oral sur"ace o" Greater s(%enoid win$,

Insertion 1Articular Ca(sule+ Disc + Nec) o" Cond&le,Function 1 9rotraction o" disc in con0unction wit%

ele!ator uscles,



Au*iliar& uscles

6uccinatorOr#icularis Oris

Ton$ue

9osterior nec)

Muscles:Sternocleidoastoid+ Tra(eius+ Intrinsicnec) uscles,

NE'E S2994Y:Mandi#ular di!ision o"

Tri$einal ner!e,



6uccinator P w%istlin$ Muscle

Ori$in :u((er f#res 1 "ro Ma*illa o((osite to

olar teet%

4ower Fi#res 1 "ro Mandi#le o((osite to

Molar teet%,Middle Fi#res 1 Fro (ter&$oandi#ular

ra(%ae,

Insertion :

To t%e 2((er 3 4ower li(s,

Action : Flattens c%ee) a$ainst $us 3 Teet%,



6uccinator Mec%anis=

It is a continous uscle #and t%at encircles t%edentition 3 is su((orted at t%e (%ar&n$eal tu#ercle,

Co(onentsK Or#icularis oris+ 6uccinator+ Su(eriorconstrictor o" (%ar&n*, O((osin$ t%e #uccinatorec%anis is a !er& (ower"ul uscle 1 Ton$ue,



T%e Force e*erted #& t%e 4i( usculature

anteriorl& 3 #uccinator 3 uscles o" t%ec%ee) (osteriorl& is counteracted #& t%e"orce e*erted #& t%e ton$ue,T%us#alanced "orce is transitted to t%e

Teet% 3 su((ortin$ #one,



An& c%an$e in t%e e-uili#riu o" 6uccinator ec%anis4eads to Malocclusion, THE QM<s 1Muscles+Mal"oration+MalocclusionKGra#er+AJODO > June 5R>?KR7Oral %a#its li)e t%u# suc)in$+ ton$ue t%rustin$A$$ra!ates t%e i#alance causin$ c%an$es in dentition 1

Constricted a*illar& arc%+ increased anterior (roclination+

C4INICA4 SIGNIFICANCE o" 62CCINATO' MECHANISM 1 HY9E'ACTIE,



Su(ra %&oid uscles In"ra %&oid uscle

GENIOHYOID THY'OHYOID

MY4OHYOIDSTE'NOHYOID

DIAGAST'IC + STY4OHYOIDOMOHYOID

Function :ele!ates t%e %&oid #one 3

de(resses t%e Mandi#le w%en t%e out% is wide o(enor a$ainst resistance,

In"ra %&oid :4owers %&oid #one allowin$su(ra%&oids to de(ress andi#le,



Mo!eents o" t%e andi#le=

De(ression 1 4ateral9ter&$oid,

Dia$astric+ Genio%&oid3 &lo%&oid uscle%el(s w%en out% iso(ened wide or a$ainstresistance+

Ele!ation 1 Masseter+ Te(oralis+ Medial(ter&$oid,

9rotrusion 1 4ateral9ter&$oid ,

'etraction K Te(oralis,

4ateral 5side to side 7 1

Medial 3 lateral(ter&$oid,



F2NCTIONA4 MOEMENTS OFMANDI64E=

It Can #e o!ed onl& in certain directions,

T%e (ostural sta#ilit& alon$ wit% (riar&o!eents,

6ASIC 9OSITIONS:

9HYSIO4OGIC 'EST

CENT'IC 'E4ATION

INITIA4 CONTACT

CENT'IC OCC42SION

MOST 'ET'2DED 9OSITIONMOST 9'OT'2DED 9OSITION

HA6IT2A4 'ESTING 9OSITION

HA6IT2A4 OCC42SION 9OSITION,



9HYSIO4OGIC 'EST 9OSITION

Earliest 9osture 9osition to #e de!elo(ed,Mandi#le is sus(ended "ro t%e cranial #ase #&

cradlin$ usculature,

Jaws are se(arated #& a constant distance,

Factors:6od& 3 Head 9osture

Slee(

9s&c%ic "actors in/uencin$ uscle tonus

A$e

9ro(rioce(tion "ro t%e dentition and uscles

Occlusal c%an$es suc% as attrition

9ain

Muscle disease and uscle s(as

Te(oroandi#ular Joint disease,



CENT'IC 'E4ATION=IT is defned as unstrained+ neutral

(osition o" t%e andi#le in w%ic%t%e anteriosu(erior sur"aces o" t%eandi#ular cond&les in contact

wit% t%e conca!ities o" t%e articulardiscs as t%e& a((ro*iate t%e(osteroin"erior t%ird o" t%eir

res(ecti!e articular einentia,Mandi#ular is de!iatin$ neit%er to

t%e ri$%t or to t%e le"t and is

neit%er (rotruded nor retruded,



INITIA4 CONTACT,,As t%e andi#le o!es to attain

noral occlusion+ t%e (oint o" initialcontact (roduces no c%an$e in t%e"unction o" te(oroandi#ular

0oint and all t%e inclined (lanes are#rou$%t to$et%er siultaneousl& int%e a*illar& 3 andi#ular teet%,

9reature contacts are seen"re-uentl& w%ic% causes e!entuall&te(oroandi#ular 0oint (ro#les,



CENT'IC OCC42SION

IT is Haronious wit% t%e Centricrelation, It is a static (osition

Teet% #rou$%t into contact wit%

unstrained relation o" t%e cond&les,Occlusal !ertical diension is

esta#lis%ed,

Ma*iu intercus(ation (ositionneed not #e "ull& attained,



MOST 'ET'2DED9OSITIONIt is re(roduci#le 1 Terinal Hin$e

9osition,

Occlusal re%a#ilitation is t%e

startin$ (oint,



MOST 9'OT'2DED 9OSITION

IT is !aria#le wit% indi!iduals3s%ows a ran$e o" o!eent o"t%e andi#le,

Flacidit& o" t%e ca(sular li$aentallows t%e cond&le to o!erride t%eanterior ar$in o" t%e einence,



HA6IT2A4 'ESTING 9OSITION

T%e (%&siolo$ic restin$ (osition isnot attaina#le due toalocclusions,

T%e (%&siolo$ic rest (ositions can#e c%an$ed due to entaldistur#ances+ enlar$ed

adenoids+te(oroandi#ular 0oint (at%olo$&+ (s&c%ictraua+out% #reat%in$ etc,



HA6IT2A4 OCC42SION9OSITION=

T%e %a#itual occlusal 9osition 3 t%eCentral Occlusal 9osition are t%e sae andt%at t%e& are in %aron& wit% Centricrelation and t%e 9ostural restin$ 9osition o"

t%e Mandi#le, In alocclusion +t%ere isas&nc%ronus acti!it& o" t%e closin$uscles in Ha#itual 3 wor)in$ #iteocclusion,

B%en t%ere is an en!ironental i#alancet%is could #e c%an$ed so t%e dentists%ould a)e sure it is t%e sae wit%re$ard to t%e (ro$ress o" t%e treatent,



F2NCTIONA4 MOEMENT OFMANDI64E=

O(enin$ o!eent :Cond&le is #rou$%t downward 3

"orward as c%in dro(s downward

3 #ac)ward,9riar& contraction o" lateral

(ter&$oid uscles,

St&lo%&oid c%an$es in len$t%,sta#iliin$ 3 ad0ustin$ acti!it&seen in

su(ra%&oid+in"ra%&oid+$enio%&oid



C4OSING MOEMENT=

More "orce is e*erted onclosure+wit% controlled rela*ationo" t%e lateral (ter&$oid uscles,

H&oid #one o!es u(ward 3"orward,



9'OT'2DING 3 'ET'2DINGMOEMENT=

9rotrusion occurs w%en t%e edial3 lateral (ter&$oid uscles contractto$et%er in con0uction wit%

controlled sta#iliin$ rela*ation o"o(enin$ uscles,

'etrusion occurs #& t%e contractiono" 9osterior f#res o" te(oralis

uscles alon$ wit% $enio%&oid+di$astric 3 &lo%&oid uscles,H&oid #one o!es (osteriorl&,



4ATE'A4 MOEMENT=,

andible is moved to left to masticate acontraction of the right lateral pterygoid muscle,

controlled relaxation of the right temporalis

muscle, the left side there is contraction of the

left temporalis and controlled relaxation of the

lateral pterygoid muscle on that side. asseter

contracts on left side, magnitude of contraction is

greater on the working side than on the balancing

side.

"ombined %ctivity &f the 'ateral pterygoid

uscle # the Temporalis uscle.



BO';ING 6ITE=,,

Bor)in$ 6ite,, To esta#lis% it t%e andi#le s%ould eit%er

o!e to t%e ri$%t or le"t, T%e lateralo!eent is #rou$%t #& t%e contraction o"

lateral (tr&$oid uscles on one side 3rela*ation on t%e o((osite side,

As t%e Teet% are #rou$%t to$et%er on anend to end relations%i( t%e Masseter

contracts on t%e le"t side as w%ento$et%er stron$ acti!it& is elicited in #ot%t%e Masseter 3 Te(oralis uscles on #ot%sides,



6ENNET MOEMENT=

Durin$ t%e lateral s%i"t o" t%e Mandi#le+ t%eArticular disc 5TMJ7 o!es towards t%e side o"

t%e wor)in$ 6ite,T%is is )nown as 6ENNETMOEMENT,

• &n the balancing side, the condyle and disk move

downward and forward on the articular eminence.

uscle activity on the balancing side consists largely of primary lateral pterygoid contraction and controlled

relaxation of the masseter, temporalis and suprahyoid

group during the lateral excursive movement.

&n the working side, there is primary contraction in themiddle and posterior fibers of the temporalis muscle and

in the posterior fibers of the masseter and some increased

activity in the hyoid group. %ctivity on the working side

depends on the si(e and nature of the bolus of food.



)here there is a malocclusion or abnormal

morphologic relationship, certain compensatory or

adaptive muscle functions may arise.

*ennett angle + the angle from the sagittal plane to the

end point of the movement of the "ondyle "entre.



TEM9O'OMANDI624A' JOINT

ain functional parts are mandibular condyle,mandibular fossa # articular disc.

inglymoarthrodial !oint "&&U/0 1&I/T.

"omponents are- andibular fossa,%rticular"apsule, 0isc, 'igaments.

%rticular surfaces covered with dense, fibrous

connective tissue.

It has a andibular $ossa also known as the

articular fossa # glenoid fossa. 2lope of articular

eminence # medial wall are ma!or determinants

of mandibular movement.



T1 is divided into 3 distinct !oint cavities by articular disc and

ligaments4

2uperior !oint cavity*etween articular disc # mandibular fossa

5esponsible for gliding movementsInferior !oint cavity

2pace between articular disc # condyle

5esponsible for hinging movements

%5TI"U'%5 0I2"4



%5TI"U'%5 0I2"4

"omposed of dense, smooth, fibrous connective tissue.

ostly devoid of nerves # blood vessels

*iconcave shape. "ondyle articulates in thin intermediate (one.

"ondyle, articular disc # mandibular fossa surrounded by soft

tissue attachments.

'I%6/T24

*ands of non-elastic collagenous tissue.

$unction is to passively limit range of movement # protect !ointstructures. 7 ligaments associated with T1.

8 functional, 3 accessory $unctional4

"ollateral 9discal: ligaments "apsular ligament Temporomandibular ligament

%ccessory4 2phenomandibular

2tylomandibular

B%en o(enin$ "ro occlusion to (%&siolo$ic rest



B%en o(enin$ "ro occlusion to (%&siolo$ic rest(osition+ rotar& or %in$e o!eents occur inin"erior 0oint,B%en andi#le o(en #e&ond (%&siolo$ic rest(osition+ articular disc $lides downward and"orward on articular einence o" te(oral #oneand cond&le rotates in in"erior ca!it&,In 6ennet o!eent cond&le rotates and o!es

sli$%tl& laterall& on wor)in$ side

>, MYOFACIA4 9AIN DYSF2NCTION



SYND'OME :

yofacial pain dysfunction 9'askin # coworkers: is

by far the most prevalent. It is primarily a muscledisorder resulting from oral parafunctional habits such

as clenching or bruxism.

9reci(itatin$ "actors: abnormal habits or a

malalignment of the !aw or dentition.Tensional2tress..odification of the occlusal surfaces of the teeth

through dentistry or accidental trauma..

2peech habits resulting in !aw thrusting..6xcessive gum chewing or nail biting..6xcessive !aw movements associated with exercise..5epetitive unconscious !aw movements associated

with bruxism.

There are four cardinal signs and symptoms of the syndrome4



9;: ain,93: uscle tenderness<98: % clicking or popping noise in the temporomandibular

!oint, 9=: 'imitation of !aw motion, unilaterally or bilaterally inapproximately an e>ual ratio, sometimes with deviation onopening.2hore- clicking or opping in the T1 is due to the !umping

$orward of the "ondyle a fraction of a second ahead of the 0isk.

DEE9 6ITE



It can #e Defned as t%e O!erla((in$ o" t%e 2((erAnterior Teet% o!er t%e lowers in t%e !ertical plane.

In dee( #ite t%e (osterior f#res o" te(oralis anddee( f#res o" asseter e*ert a (osterior t%rust ont%e cond&le and disc,4ateral 9ter&$oid uscle is under tension causin$re(eated stretc% re/e* and su#se-uent uscle

contractions and s(ass,4et% Nielson 5ANG4E >7 sa&s t%at t%e erticalMalocclusions de!elo( as a result o" Mandi#ularGrowt% ariations,T%e u(ward 3 "orward $rowt% o"t%e andi#ular cond&le o"ten %a!e reduced Anterior

Face Hei$%t,

DEE9 6ITE,,

C4INICA4 SIGNIFICANCE



It is one of the most common Malocclusion & the most

Deleterious one when considering the overall functioning of the

Masticatory Apparatus & the dental unit (STOMATOGAT!I"S#ST$M%

$ffects of deep ite' eriodontal Defects Trauma to the alatal Mucosa "ontriuting )actor in the $tiology of TMD

"lass II Malocclusion* Stronger Mandiular $levator Musculature* !igh Mentalis Activity & Deep Mento +aial )old* $verted +ower +ip*

C4INICA4 SIGNIFICANCE



6ru*is can #e Defned as a 9ara"unctionalacti!it& o" t%e asticator& s&ste w%ic%includes ti$%tenin$ 3 Teet% $rindin$,

Two t&(es 1 9riar& 3 Secondar&,

Etiolo$& :

Stress+An*iet&+Malocclusion+Cranioandi#ularDisorders+ Oral %a#its,

Clinical si$nifcance



Clinical si$nifcanceE.ects o" 6ru*is:

Toot% wear+Gurecession+attrition+o(en #ite+ cross#ite+Malocclusion,

'elations%i( #etween6ru*is+Occlusal "actors 3 oral %a#its,5Dental (ress 0ournal o" ort%odontics!ol > arPa(r >7 studies s%ows

t%at :

class II alocclusionK U + class IMalocclusionK RU,

T%ere is increase in tonic acti!it& o" 0aw



uscles,

Eotional or ner!ous tension+ (ain ordisco"ort+occlusal inter"erences increase t%e

uscle tone can lead to nonK"unctionalclenc%in$

A %i$% fllin$+a al(osed toot% or dee( o!er#iteis "re-uentl& contri#utor& ,

T



Ton$ueIt is t%e sin$le lar$est uscular or$an located inside t%e

oral ca!it&,

O((oses t%e #uccinator ec%anis,

6e$ins it<s acti!it& e!en #e"ore #irt%+w%ile it "unctions int%e swallowin$ o" ainiotic /uid,

'elati!el& one o" t%e #est de!elo(ed structure in t%e%uan #od& at #irt%,

Has aain$ !ersatile "unctional (ossi#ilities as it isanc%ored at onl& one end,



De!elo(ent o" Ton$ue=

&rginates from muscles of occipital myotomes

ucous membrane of anterior 38 rd - 'ingual

swelling and tuberculum impar.

ucous membrane of posterior ;8 rd - hypobranchial

eminence.

M2SC4ES OF THE TONG2E



M2SC4ES OF THE TONG2E,,Muscles of tongue

;: Intrinsic muscles

3: 6xtrinsic muscle

Intrinsic muscles

;: 2uperior 'ongitudinal uscle

3: Inferior 'ongitudinal uscle

8: Transverse uscle

=: ?ertical uscle.



Mo!eents o" t%e Ton$ue=

SUPERIOR AND INERIOR

!ON"I#UDINA! MUS$!E form the length

of the tongue and moves tip up and down

#RANS%ERSE MUS$!E go across the

tongue. It narrows and lengthens the tongue.

%ER#I$A! MUS$!E go up and down in the

tongue. It flattens and depresses the tongue.

E&trinsic muscles



;: @yo glossus

3: 2tylo glossus

8: enio glossus

=: alato glossus

"enioglossus 4Origin 4 enial tubercle of mandible



Insertion 4 *ody of hyoid and length of tongue

unction 4 0raws the tongue forward.

St'loglossus 4 Origin 4 2tyloid process

Insertion 4 'ateral surface of tongue

unction 4 )ith palatoglossus draw the dorsum up and back during swallowing.

('oglossus 4 Origin 4 reater @orn of hyoid

Insertion 4 'ateral side of tongue

unction 4 0raws the tongue backwards and

downwards as in yawning

Palatoglossus 4 Origin 4 alatine aponeurosis

Insertion 4 'ateral side # dorsum of tongue

unction 4 %long with stylo glossus, it draw the

dorsum of tongue up and back during swallowing.



Noral Ton$ue (osture s



Noral Ton$ue (osture sA6NO'MA4 9OST2'E



C4INICA4 SIGNIFICANCE=

A#noral acti!ities o" t%e ton$uecauses:

9rotrusion 3 s(acin$ o" t%e a*illar&incisors,

9osterior cross#ite,

O(en #ite,

S(eec% (ro#les,

Oral %a#its li)e out% #reat%in$+Ton$ue t%rustin$ can a$$ra!ate t%eMalocclussion,

HY9E'ACTIE MENTA4IS



HY9E'ACTIE MENTA4IS=

Co(ensator& entalis uscle

acti!it& a& a$$ra!ate t%is (rocessand e*ert a stron$ retractin$ "orceon andi#ular incisor,

Due to t%e strain o" t%e entalisuscle,



F2NCTIONS OF TONG2E

TASTES9EECH

MASTICATION

DEG42TITION

F2NCTIONS OF



F2NCTIONS OFSTOMATOGNATHIC SYSTEM=

'ES9I'ATIONS9EECH

MASTICATION

DEG42TITION



'ES9I'ATION

'es(iration



'es(iration= Mout% 3 Nose "ors t%e anatoic #e$innin$ o" t%e

'es(irator& s&ste,

'es(iration unli)e astication 3 swallowin$ is anin%erent re/e* acti!it&,

'es(iration is due to t%e "antasticall& eVcient s(litsecond o(enin$ and closin$ o" t%e e(i$lottis+ )ee(in$ outt%e "ood #ut (erittin$ t%e entr& o" li"e $i!in$ air,

6osa and %is coKwor)ers %a!e anal&ed res(iration int%e in"ants and "ound t%at+ -uiet res(iration is t&(icall&carried out t%rou$% t%e nose+ wit% t%e ton$ue in(ro*iit& to (alate+ o#structin$ t%e oral (assa$ewa&,

6ot% t%e (%ar&n* and lar&n* are acti!e durin$ res(irationand it is in t%is area t%at t%e in"ant di.erentiates#etween res(iration and associated acti!ities suc% as t%ecou$% +cr& or sneee, 9osture also %as a si$nifcant e.ect

on res(iration,

9ositional sta#iliation o" t%e dorsal (ortion



o" t%e out% is a "unction s%ared wit% t%e(%ar&n* and is also a(art o" t%e (%ar&n$eal

(artici(ation in res(iration stated #& JAMES6OSMA >,

'es(iration starts at w)s o" intrauterineli"e,

JAMES 6OSMA > K Mandi#les o!esd d d t l



downward and ton$ue also o!esdownward and "orward "ro (osterior

(%ar&n$eal wall+ t%us c%ild (erits airt%rou$% nose and (%ar&n* and t%en intolun$sNeonates are o#li$ate nasal #reat%ers

So i" nasal airwa& is #loc)ed sur!i!al isdiVcult

9atenc& o" airwa& in t%e nose and t%e

ca!it& is aintained #& t%e #on& s)eleton3 ada(ti!e (osture o" t%e ton$ue, In t%e(%ar&n* +t%e (atenc& is a$ain de(endentu(on t%e tone o" t%e uscles o" t%e

ton ue+so"t alate 3t%e 9%ar n eal walls,



MECHANISM OF 'ES9I'ATION

Nasal airwa& "unction %as #eeni(licated as an etiolo$ical "actor

in Dento"acial de!elo(ent,

li i l i if



Clinical Si$nifcance=MO2TH 6'EATHING

T%ose w%o #reat%e orall& e!en inrela*ed 3 rest"ul (osition,

Due to learned Ha#it or t%e Airwa&

(osition, T%is %as #een attri#uted as one o" t%e

9ossi#le "actors "or Maloclussion,

Xualit& o" air is in"erior 3 a#norall&a.ects t%e entire s&ste,

It (roduces altered andi#ular (osition3 e*tended ton$ue (osture 1 lon$ "ace

or Adenoid "acies,

Classifcation:



Finn >?@ %as classifed out%#reat%in$ into t&(es :

O#structi!eHa#itual

Anatoic

O#structi!e 1 Co(lete or 9artial o#structionto t%e noral /ow o" air t%rou$% t%e nasal(assa$es,

Causes : De!iated nasal se(tu+Aller$ic

r%initis+C%ronic in/aation o" t%e nasalucosa+ localied #eni$n tuors+ o#structionin t%e #ronc%i or 4ar&n*+ Enlar$ed adenoids or

Tonsils,

Anatoic : A (erson %as s%ort u((er li(,C l t l " t% t% it% t



Co(lete closure o" t%e out% wit%outundue e.ect is not (ossi#le,

Ha#itual : T%e (erson continuousl& #reat%est%rou$% %is out% #& "orce o" %a#it+ alt%ou$%t%e a#noral o#struction %as #een reo!ed,

Ot%er causes o" out% #reat%in$ :

O#structi!e Slee( A(noea + T%u# Suc)in$,



T%eories o" Mout% 6reat%in$



T%eories o" Mout% 6reat%in$Accordin$ to Co(ression t%eor&<< $i!en #&

Norland 5>>?7 constriction o" t%e Ma*illar&arc% is related to lowered (osition o" Ton$uew%ic% %a((ens due to nasal o#struction inorder to "acilitate #reat%in$,

Toes 5>?@7 coined t%e ter Adenoid Facies<to descri#e t%e dento"acial c%an$es associatedwit% c%ronic nasal airwa& o#struction,

4inder 1 Aronsen 5>@K ?7 su((orted t%e

relations%i( #etween nasal o#struction 3cranio"acial 3 Dental 9atterns,

Solow 3 ;rei#or$ 5>@@7 1o#struction to t%eairwa& is a a0or "actor in deterinin$ t%e

Facial Mor(%olo$&,

Increase in t%e Facial Hei$%t

E*tension OrTi((in$ #ac)



EFFECT

S:Mout%

#reat%in$

Increase in t%e Facial Hei$%t,

Cloc)wise 'otation o" t%eMandi#le,Dr&ness o" out%

Gin$i!itis and increased dentalcaries,

Hi$% 9alatal !ault + Gu&Sile,

Su(ra eru(tion o"9osterior teet%,

Stretc%ed c%ee)Anterior o(en #ite+Increased o!er0et+

Narrow a*illar& Dentalarc%+ 9osterior

cross#ite,

Ti((in$ #ac)o" Head,

4owerin$ o"t%e Mandi#le,

9ositionin$ o" Ton$ue

in"eriorl& 3Anteriorl&,

ADENOID FACIES



ADENOID FACIES

S%ort +T%ic) +Inco(etent + Flaccid u((er li( 3curled o!er lower li(,

Increased lower anterior Facial Hei$%t,

4on$ 3 Narrow "ace,

ti ti



astication IT is t%e (rocess #& w%ic% "ood is crus%ed

and $round #& teet%

IT is Defned as t%e reduction o" "ood in sie +c%an$e in consistenc& + i*in$ it wit% sali!aand "orin$ into a #olus suita#le "orswallowin$,

Action o" #rea)in$ down o" "ood + (re(arator&to de$lutition,

T%e entire Stoato$nat%ic s&ste (la&s a!ital role,

Mastication o" Food Trans(orted #&

de$lutition Di$esti!e Canal,

NE2'OM2SC24A' ACTION



NE2'OM2SC24A' ACTION

Hi$%l& or$anied co(le* o"neurouscular 3 di$esti!e acti!ities,

C%ewin$ is a Co(le* re/e* acti!it& +&et can #e #rou$%t to conscious control

at an& tie, 5O)eson7 Two si(le 6rain Ste Acti!ities:

>, Jaw O(enin$ 'e/e*K Toot% 9ressure or

Tactile stiulation o" wide areas o"out% 3 li(s,

, Jaw Closin$ 'e/e*K Follows t%estretc%in$ o" t%e ele!ator uscles

durin o enin S%errin ton 3 ;in et

IT is a sel" 9er(etuatin$ c&cle 5Dellow 34und7



4und7

Bit%in t%e #rain ste t%ere is a (ool o"

neurons res(onsi#le "or (recise tiin$ o"acti!ities L CENT'A4 9ATTE'NGENE'ATO',

T%us c%ewin$ is considered as a co(le*

re/e* acti!it&FO'CE OF MASTICATION:

"eale K ,?KRR, )$

ale K ,KR,R )$

CHEBING 9ATTE'N



CHEBING 9ATTE'NAD24T !s CHI4D=

C%ild :

Mastication de!elo(ent re-uires de!elo(ent o"



Mastication de!elo(ent re-uires de!elo(ent o"new sensor& otor (attern,

Jaw uscles #e$in to learn astication (rocess w%en

a*illar& and andi#ular teet% touc% eac% ot%er5 Mo&ers in >R7

Gets Sta#ilied w%en t%e co(lete (riar& dentitionis eru(ted , T%e transition to Adult c%ewin$ (atternoccurs at > &rs, o" a$e 5Canine eru(tion7,

Mo!es t%e 0aw frst laterall& on o(enin$ 3 t%en t%easticator& c&cle is (er"ored,

AD24T:

Jaw is o(ened strai$%t down + o!es t%e 0aw laterall&

3 t%en #rin$s a#out t%e teet% into contact,C%ewin$ ust #e learned +occurs onl& a"ter teet%

eru(tion,

T%e Masticator& en!elo( is usuall& descri#ed as a

Tear Dro( s%a(e

Fletc%er suaries recent wor) on asticator&



Fletc%er suaries+ recent wor) on asticator&stro)e in t%e adult+ usin$ t%e si* (%ases outlined #&Mur(%&,

M2'9HY<S SI ST'O;ES OF MASTICATION

The preparatory phase

In w%ic% "ood in$ested and (ositioned #& t%eton$ue wit% in t%e oral ca!it& and t%e andi#le iso!ed towards c%ewin$ side,Mur(%& Identifed a sli$%t de!iation to t%e o((ositeside 0ust #e"ore t%e #e$innin$ o" Mastication+ w%ic%%e called t%e 9recise #e$innin$ o" t%e 9re(arator&(%ase,Food contact It is c%aracteried #& a oentar& %esitation in

o!eent, T%is is inter(reted to #e a 9%ase

The crushing phase

It starts with high velocity then slows as the food is crushed and



It starts with high velocity then slows as the food is crushed and

packed. Equal contact on both sides.

Tooth contact

Accompanied by a slight change in direction According to Murphy all

reflex adustments of the musculature for tooth contact are completed

in the crushing phase before actual contact is made.!educed

Muscular activity is noted.

The grinding phase

The Teeth slide in the correct direction Towards the intercuspal

position.Helps to grind the food into a paste.

Centric occlusion

This phase is a connecting link between Mastication &

swallowing – referance position to CNS.

"hen movement of the teeth comes to a definite and distinct stop at

a single terminal point #from which the preparatory phase of next

stroke begins.

DEG42TITION=



DEG42TITION=

De$lutition is t%e act or 9rocesso" swallowin$,

6ot% Suc)lin$ 3 swallowin$o!eents start de!elo(in$

"ro nd

w) o" intrauterine li"e, Series o" coKordinated uscle

contraction t%at o!es t%e#olus o" "ood "ro oralca!it&

t%rou$% eso(%a$us to stoac%De(ends on fneness o" "ood

and de$ree o" lu#rication o"#olus

MECHANISM OF SBA44OBING



MECHANISM OF SBA44OBING,,

INFANTI4E SBA44OB



INFANTI4E SBA44OB=

Suc)lin$ is associated wit% t%et&(e o" In"antile swallowin$Mec%anis , It is also called as

isceral Swallow, Fletc%er stated t%at : T%e

in"antile swallow is #ecause o"t%e di.erence in sie oror(%olo$& o" t%e oral ca!it& andt%e increased ton$ue sie

Mo&er listed t%e "eatures o"



In"antile Swallow:

Jaws are a(art wit% t%e ton$ueinter(osed #etween t%e $u(ads,Mandi#le is sta#ilised #& t%e

contraction o" uscles o" "aciale*(ression and #& t%e inter(osedton$ue,

Swallowin$ is $uided andcontrolled #& sensor& interc%an$e#etween li(s and ton$ue



S2C;4E SBA44OB



S2C;4E SBA44OB=Suc)lin$ consists o" sall ni##lin$

o!eents o" li(s around ot%er<s #reastto stiulate soot% uscle contractionw%ic% causes s-uirtin$ o" il) into out%

Once il) is s-uirted into out%+ t%eneonate (ositions t%e ton$ue anteriorl& sot%at t%e ton$ue is in contact wit% lower li(,

T%is "acilitates de(osition o" il) on

ton$ueOnce de(osited t%e in"ant o!es t%e

ton$ue so t%at t%e il) /ows (osteriorl&into (%ar&n* and eso(%a$us

Accordin$ to 6OSMA : Head is e*tended+ton$ue



$ $ elon$ated and low in /oor o"

out%+0aws a(art and li(s (ursed

around ni((le,Mandi#le is (rotruded'%&t%ic contraction o" ton$ue and "acial

uscles sta#ilise t%e andi#le,

MAT2'E SBA44OB=



Bit% t%e c%an$e in seisolid and solid "ood and t%e

eru(tion o" t%e teet% t%ere is also a odifcation o"swallowin$ act,

T%e ton$ue no lon$er is "orced into t%e s(ace #etween$u (ads or incisal sur"aces o" teet%+ w%ic% actuall&

contact oentaril& durin$ t%e swallowin$ act,

Mandi#ular t%rust diinis%es durin$ transitional (eriodo" K> ont%s, T%e andi#le closin$ uscles ta)eo!er ore o" t%e role o" sta#iliin$ t%e andi#le as t%e

c%ee) and li( uscles reduce t%e stren$t% o" t%eircontraction,

T%e ti( o" t%e ton$ue is no lon$er o!in$ in and out#etween anterior $u (ads #ut assues a (ositionnear t%e incisi!e "oraen at t%e oent o" de$lutition

A"ter eru(tion o" teet% and s%i"t to seisolid and solid "ood in"antile swallow



solid and solid "ood+ in"antile swallowdisa((ears at t%e end o" frst &ear o" li"e,

9ro(rioce(ti!e i(ulse coe into (la& T%e c%an$e to t%e adult swallowin$ (attern

occurs $raduall& in + it %as #een called t%etransitional (eriod, Incisors coe to$et%er

Ti( o" t%e ton$ue lies #e%ind incisors durin$swallowin$ act

At >? ont%s o" a$e ature swallowin$(attern de!elo(s co(letel& in a c%ild

Neurouscular aturation+ c%an$e in %ead(osture +$ra!itational e.ect on andi#le

are conditionin$ "actors,

2suall& #& >? ont%s o"a$e+ t%e ature swallow



a$e+ t%e ature swallowoccurs, Features listed#& Mo&ers are 1

>7 T%e teet% are to$et%er7 T%e andi#le issta#ilied #& contractiono" t%e andi#ularele!ators,Anterior

Mandi#ular t%rustdisa((ears,7 T%e ton$ue ti( is %elda$ainst t%e (alate+a#o!e and #e%ind t%e

incisors,R7 T%ere is inialcontraction o" li(s durin$t%e ature swallow,

T%e T%ree I(ortant 9reKre-uisites"or t%e Mature Swallow are :



"or t%e Mature Swallow are :

5>7Esta#lis%ent o" (ressure

$radient, 57(re!ention o" re/u*,

57(rotection o" airwa&,

STAGES IN DEG42TITION,,



STAGES IN DEG42TITION,,9%ases o" de$lutition :

Fletc%er di!ides t%e de$lutition c&cle in R(%ases+ %i$%l& inte$rated ands&ner$isticall& coordinated,

>7 9re(arator& 9%ase7 Oral (%ase7 9%ar&n$eal (%aseR7 Eso(%a$eal (%ase,

First two sta$es are !oluntar&

Second two sta$es are in!oluntar&

>7 Preparatory 9%ase :



Starts as soon as Solids are ta)en in+ or a"ter t%e#olus %as #een asticated ec%anicall& w%ic%

is i*ed wit% sali!a a)in$ it suita#le "orswallowin$ ,T%e li-uid or #olus is t%en in aswallow 1 (re(arator& (osition on t%e dorsu o"ton$ue, Ton$ue (la&s a !ital role 1 "ood is adeinto a co%esi!e #all,

NE2'OM2SC24A' ACTION K 4i( closure K %old t%e "ood in t%e out% K Tension in la#ial and #uccal usculature

to close t%e anterior and lateral sulci,

K 4ateral rollin$ otion o" ton$ue to(osition "ood on t%e teet%,

K 6ul$in$ "orward o" t%e so"t (alate to sealoral ca!it& and widen t%e airwa&

T%e oral ca!it& is sealed #& li( and ton$ue,

7 Oral phase : Food o!es "ro oral ca!it& toanterior "aucial arc%es and re/e*i!e swallow isi iti t d



initiated

Neurouscular action

K Ton$ue a)es !ertical contact anteriorl&wit% al!eolar rid$e

K ertical ton$ue to (alate contact (ro$ress(osteriorl& (ro(ellin$ t%e #olus to (%ar&n*

K Ton$ue ele!ate and o!e in anterior to(osterior direction

T%is sta$e lasts "or less t%an > second

T%e co#ined o!eent create a soot% (at%"or t%e #olus as it is (ulsed "ro t%e oral ca!it&#& t%e wa!eKli)e ri((in$ o" t%e ton$ue,

T%e oral ca!it&+ sta#ilied #& t%e uscles o"

asticatin aintains an anterior and lateral seal

7 The pharyngeal phase :6e$ins as t%e #olus (ulses t%rou$% 9%ar&n*,



$ ( $ & T%e (%ar&n$eal tu#e is raised u(ward andt%e naso(%ar&n* is sealed o. #& closure o"t%e so"t (alate a$ainst t%e (osterior(%ar&n$eal wall,

Trans(ort "ood "ro 9%ar&n$eal arc%es to

Eso(%a$us,9rotect airwa& #& (re!entin$as(iration

Neurouscular action5>7elo (%ar&n$eal closure to (re!ent

entr& o" "ood or li-uid into t%e nasal ca!it&579%ar&n$eal (eristalsis to (ro(el #olus

t%rou$% (%ar&n* and clear "ood residue"ro t%e (%ar&n$eal recess suc% as

!allecular and ri"or sinuses

5R7O(enin$ o" cricoK(%ar&n$eal re$ion allows #olus (assa$einto eso(%a$us



R7 The esophageal phase :

coences as "ood (asses t%e crico(%ar&n$eal s(%incter, B%ile(eristaltic o!eent carries "ood t%rou$% t%e eso(%a$us+ t%e%&oid #one (alate and ton$ue return to t%eir ori$inal (ositions,

Trans(orts t%e "ood #olus "ro u((er eso(%a$al s(%incter to

t%e stoac%Neurouscular action

K e*tends "ro le!el o" cricoid cartila$e to t%e cardia o" stoac%wit% a!era$e len$t% o" c in ale and c in "eale

K durin$ eso(%a$eal sta$e t%ere is $eneration o" (riar& wa!ewit% "orce o" >c water (ressure w%ic% o!es t%e #olus alon$len$t% o" eso(%a$usSecondar& wa!e can #e $enerated w%ent%ere is increased (ressure in idKeso(%a$us

Secondar& wa!e is initiated asresidual "ood is le"t a"ter t%e



residual "ood is le"t a"ter t%eco(letion o" t%e (riar& wa!e,

Tertiar& wa!e occurs in t%e elderl&and in (at%olo$ic states, It occurs indistal eso(%a$us and a)es a nonK

(ro$ressi!e+ cor)screw li)e otionEso(%a$eal sta$e lasts ?K

seconds,

An a(neal (ause #etween > and ,seconds in duration occurs durin$oral and (%ar&n$eal sta$es

54o$eann >?7



Clinical si$nifcance=A# l ll i tt i d #



A#noral swallowin$ (attern is caused #& TONG2E TH'2ST or as TONG2E TH'2ST

SYND'OME,5w%en t%e isceral swallowin$(ersist a"ter R &rs o" a$e 1 oro"aciald&s"unction 7

Features:

9rotrusion o" t%e ti( o" t%e ton$ue,No toot% contact o" t%e olars,

Contraction o" t%e (erioral uscles durin$ t%ede$lutional c&cle,

ETIO4OGY



ETIO4OGY,,

Oral %a#its 5t%u# suc)in$7An)&lo$lossia or acro$lossia

Tonsillar tissue enlar$ed

CNS disorders 5to (roduce oral

seal s%ows au*iliar& "unction72((er res(irator& tractin"ections

H&(osensiti!e (alate

6ottle "eedin$ Hereditar&

ETIO4OGY



TONG2E

TH'2ST

9'IMA'Y

SECONDA'YANTE'IO'

4ATE'A4

COM94E

HA6IT2A4

ADA9TIE

ENDOGENO2S

classifcation



classifcation

T&(e > 1 Non de"orin$ ton$uet%rust

T&(e 1 De"orin$ anterior

ton$ue t%rustsu#$rou( > 1 Anterior o(en

#ite

su#$rou( 1 Associated(rocu#enc& o" anterior teet%

su#$rou( 1 Associated

(osterior cross #ite

T&(e 1 De"orin$ lateral ton$ue%



t%rustsu#$rou( > 1 9osterior o(en #itesu#$rou( 1 9osterior cross #itesu#$rou( 1 Dee( o!er #ite

T&(e R 1 De"orin$ anterior and

lateral ton$ue t%rust su#$rou( > 1 Anterior and

(osterior o(en #ite su#$rou( 1 Associated

(rocu#enc& o" anteriorteet%

su#$rou( 1 Associated(osterior cross#ite,

EFFECTS,,



EFFECTS,,

Anterior o(en #ite

4ateral or (osterior o(en #ite

9roclined u((er incisor

H&(otonic u((er li( w%ic% a((ear retractedor s%ort

6ilateral narrowin$ o" a*illar& arc%,

T%e in/uence o" Ton$ue on Dento"acialGrowt%KJo%n Meaw+An$le > states t%atMalocclusion is "re-uentl& associated witunusual "or or "unction o" t%e so"t tissuesw%ic% a& ran$e "ro a si(le suc)in$%a#it to a Q"ull "an< ton$ue t%rust wit% onl&

(osterior olars in contact,

SPEECH



SPEECH

A 4EA'NEDACTIITY

2nli)e astication+de$lutition and res(iration+ w%ic% arere/e*i!e in nature+ s(eec% is lar$el& a

learned acti!it& de(endent on t%eaturation o" t%e 6ein$,

T%e low (laceent o" lar&n* w%ic%ena#les %uan !ocal tract to

T%e well de!elo(ed !elo(%ar&n$ealec%anis aids in s(eec%,



2ni-ue "eature o" Huan 6ein$s,

Neuro9%&siolo$&:S(eec% (roduction #e$ins in otor areaand otor co ordination o" articulation

"ro #ilateral (recentral $&ri,Ner!e i(ulses are "ed to id#rain

t%rou$% (&raidal tract, Here s(eec%is fne tuned,

Cranial ner!es in!ol!ed are tri$einal+"acial+ !a$al and %&(o$lossal,

T%e 4an$ua$e area First disco!ered is(resent in "rontal lo#e in le"t %eis(%ere



( (called 6'OCA<s A'EA 59aul 6roca7 also it

deals wit% $raar,Second disco!ered lan$ua$e area

BE'NIC;E<s A'EA 5Carl Bernic)e+Geran Neurolo$ist7 (resent in u((er(ortion o" te(oral lo#e,

6roca<s area and Bernic)eZs areaconnected #& a tract o" ner!es called

Arcuate "ascilicus,An$ular $&res %al"wa& #etween

Bernic)eZs area and !isual corte* o"occi(ital #one



Ina#ilit& to s(ea) K a(%asia

Ina#ilit& to read K ale*ia

4earnin$ disa#ilit& K d&sle*ia

Ina#ilit& to write K a$ra(%ia

Ina#ilit& to (roduce s(eec% 1 6roca<s

A(%asia

De!elo(ent o" s(eec% "ollows t%e (rinci(le o" "ront to #ac) aturation



De!elo(ent o" s(eec% "ollows t%e (rinci(le o" "ront to #ac) aturation,First sounds (roduced are #ila#ial sounds,Consonants K (roduced wit% co(lete or (artial closure o" u((er !ocal

tract5a#o!e t%e lar&n*7owels 1 (ronounced wit% o(en !ocal tract

MECHANISM OF S9EECH

Ai Fill t% 4



Air Fills t%e 4un$s

'i# Ca$e Contracts 3 "orces air"ro 4un$s to Trac%ea,

Trac%ea5 a(litude o" sound7 Trans(orts Air to ocal tract,

ocal Tract 5s%a(es t%e sound7

(asses on to t%e 9%ar&n* + Mout% +Nose,

Articulation o" t%e soundde(ends on t%e (osition o" t%e

ton$ue teet% li(s

C4INICA4 SIGNIFICANCE,,



4i( D&s"unctions are o#ser!ed w%ilet%e (atient is s(ea)in$ 3swallowin$ ,

4IS9ING 3 STAMME'ING

T%ese are coonl& occurrin$s(eec% de"ects,S(eec% de"ect create diVcult& "or t%e

c%ild w%ile s(ea)in$, T%e c%ild a&de!elo( in"eriorit& co(le*, Hede!elo(s a sense o" insecurit&,

4IS9ING



T%is s(eec% de"ect in!ol!es c%an$e o" sound o"

letters and words, T%e Ton$ue lies on t%e to( o" t%elower incisors,Etiolo$&:

'etained 3 continued In"antile ode o" S(eec%,

O(en 6ite

Ma*illar& 9rotrusion

Mandi#ular 'etrusion,

STAMME'ING



In staerin$ t%e c%ild "ails to (roduce an&sound "or soetie, T%ese create eotionaltension and diVcult& in social ad0ustent,

ETIO4OGY:

Hereditary Emotional tension

Lack of balance among two hemispheresof brain.



Toot% 9osition 3 S(eec% #& Nicola

,C,4,Jo%nson +An$le Au$ > states t%atDental Irre$ularities s%ows a relations%i( wit%S(eec% disorders, T%ere is no defniti!e (roo"t%at Alteration o" toot% (osition can i(ro!eArticulation Disorders,

Class ll+ di! > alocclusion ,

EFFECTS OF S9EECH ON MA4OCC42SION



Anterior O(en 6ite

Class > wit% issin$ anterior teet% E*cessi!e o!er#ite 3 o!er0et, Class lll alocclusions wit% total a#sence

o" incisal contact,

4i( inco(etanc wit% a#norall&(ositioned ton$ue,

T%ese alocclusions e.ects t%e (roductiono" !owels 3 consonants leadin$ to s(eec%

de"ects, JENSON studied t%e anterior teet%relations%i( 3 s(eec% in noral 3 Class lldi! l alocclusions s%owin$ t%at s(eec%

Man& d&s"unctions are ac-uired in t%eearl& sta$es o" de!elo(ent



earl& sta$es o" de!elo(ent,

Malocclusions t%at are ac-uired as aresult o" d&s"unctions can usuall& #etreated si(l& #& eliination o"distur#in$ en!ironental in/uences+

w%ic% will "oster noral de!elo(ent, T%e etiolo$& o" s(eec% (ro#les%ould #e reco$nied and (ro(er

treatent s%ould #e $i!en, T%e (resence o" s(eec% de"ects in

c%ild%ood is due to lac) o" suVcienttrainin$ and aturit&,

CONC42SION



It is !ital t%at +t%orou$%a((reciation o" t%e d&naicso" t%e Stoato$nat%ic s&ste

is essential "or t%eOrt%odontist +as t%e)nowled$e o" noral

or(%olo$& 3 acti!it& is !er&i(ortant so as to reco$nise3 di.erentiate t%e

'EFE'ANCE



Ort%odontic Dia$nosis 1 T%oas'a)osi+T%oas ,M,Gra#er +Irtrud Jonas,

Ort%odotics 1 O 9ra)as% ;%ar#anda,

Ort%odotics 9rici(les 3 (ractice 1 Gra#er 5 rdEdition 7

Te*t#oo) o" Cranio"acial $rowt% 1 9re)uarsrid%ar,

Conte(orar& ort%odontics 1 Billia ; 9roVt,

Gra&<s anato&+ Clinical anato& 1'ic%ard S

Snell Te*t#oo) o" Anato& 1 Indir#ir sin$%

An$le Ort%odontics,



STOMATOGNATHIC SYSTEM.pptx

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