Neuromuscular co ordination of stomatognathic system.pptx

Neuromuscular coordination of stomatognathic system

1. NEUROMUSCULAR COORDINATION OF STOMATOGNATHIC SYSTEM Presented by Beulah Celestee. S 1 st Year PG

2. INTRODUCTION Neurologic control system coordinates activities of entire masticatory system Consists of nerves and muscles

3. 01 Introduction CONTENTS 02 Anatomy of neuromuscular system 03 Functions of neuromuscular system 04 Mastication 05 Swallowing 06 Speech

4. ANATOMY OF NEUROMUSCULAR SYSTEM NEUROLOGIC STRUCTURES: NEURON Neurologic structures Muscles

5. AFFERENT AND EFFERENT NEURON

6. SENSORY RECEPTORS EXTEROCEPTORS: Sensory receptors found in the peripheral tissues such as the skin and oral mucosa

7. NOCICEPTORS: Discomfort and pain. PROPRIOCEPTORS: position and movement of the mandible and associated oral structures. INTEROCEPTORS: status of internal organs

8. DEPICTION OF PERIPHERAL NERVE INPUT INTO THE SPINAL CORD

9. MUSCLES MOTOR UNIT

10. MUSCLE FIBER-MOTOR NEURON RATIO Low muscle fiber -motor neuron ratio:Inferior lateral pterygoid Increased muscle fiber -motor neuron:Masseter

11. MUSCLE FUNCTION Isotonic contraction Isometric contraction Eccentric contraction

12. MUSCLE SENSORY RECEPTORS Muscle spindles Golgi tendon organs Pacinian corpuscles Nociceptors MUSCLE SPINDLES

13. NEUROMUSCULAR FUNCTION MYOTATIC REFLEX

14. NOCICEPTIVE REFLEX

15. FUNCTIONS OF MASTICATORY SYSYTEM Mastication Swallowing Speech

16. MASTICATION CHEWING STROKE: Opening and closing movement of the mandible

17. CHEWING STROKE IN FRONTAL PLANE

18. CHEWING STROKE IN SAGITTAL PLANE OF WORKING SIDE

19. CHEWING STROKE IN SAGITTAL PLANE OF NON WORKING SIDE

20. TOOTH CONTACTS DURING MASTICATION TYPES OF CONTACTS: Gliding Single Tooth contacts relay sensory information back to the central nervous system regarding the character of the chewing stroke

21. FORCES OF MASTICATION MAXIMUM BITING LOAD: Female: 35.8- 44.9 kg Male: 53.6- 64.4 kg On molars: 41.3- 89.8 kg On central incisors: 13.2- 23.1 kg Biting force on patients with CD is ¼ th of subjects with natural teeth

22. ROLE OF SOFT TISSUES IN MASTICATION LIPS: Guide and control intake Seal off oral cavity TONGUE: Presses food against hard palate Pushes food onto occlusal surface of teeth BUCCINATOR MUSCLE: Pushes food onto occlusal surface of teeth from buccal side

23. SWALLOWING Series of coordinated muscular contractions that moves a bolus of food from the oral cavity through the esophagus to the stomach. During swallowing, lips are closed. The teeth are brought up into their maximum intercuspal position

24. Infantile swallow Somatic swallow

25. FIRST STAGE OF SWALLOWING

26. SECOND STAGE OF SWALLOWING

27. THIRD STAGE OF SWALLOWING

28. FREQUENCY OF SWALLOWING 590 times/day Eating:146 cycles Between meals: 394 cycles During sleep: 50 cycles

29. SPEECH Pitch -Controlled contraction and relaxation of the vocal cords Resonance and articulation of the sound- precise form assumed by the mouth

30. ARTICULATION OF SOUNDS BILABIAL SOUND P,B,M-lips come together and touch LABIODENTAL SOUND F,V-lower lip touches the incisal edges of the maxillary teeth

31. LINGUOALVEOLAR SOUND T,D- tip of the tongue reaches up to touch the palate directly behind the incisors LINGUODENTAL SOUND TH-Tongue touches maxillary incisors

32. SIBLIANT SOUND S- incisal edges of the maxillary and mandibular incisors approximate (but do not touch) K or G the posterior portion of the tongue rises to touch the soft palate

33. PROSTHODONTIC CONSIDERATIONS FACTORS AFFECTING COMPLETE DENTURES DUE TO NEUROMUSCULAR CORDINATION: OCCLUSION: Neuromuscular or myocentric occlusion-relationship between maxilla and mandible recorded in rest position, It is influenced by the muscles of mastication

34. ESTHETICS The memory patterns of facial expression are regained through stimulation of neuromuscular system in patients with neuromuscular disorder In case if neuromuscular patients are edentulous the denture esthetics is achieved by repositioning of the orbicularis oris muscle

35. RETENTION AND RESISTANCE TMJ, the maxillary and mandibular teeth with overall neuromuscular system will lead to complex maxillary and mandibular movement These movements are coordinated by maxillary and mandibular musculature which aids in fixation and stabilization of one position to another

36. TREATMENT OF PATIENTS WITH NEUROMMUSCULAR INCORDINATION MYASTHENIA GRAVIS: Use of lingualized occlusal scheme Implant supported complete denture

37. NEUTRAL ZONE TECHNIQUE

38. CEREBRAL ATAXIA Non-anatomic teeth Dawson’s bimanual manipulation technique for recording centric jaw relation

39. High strength heat cure resin is used as the denture base material reinforced with metal mesh Neutral zone technique

40. FACIAL PARALYSIS Detachable and un detachable cheek plumper Neutral zone technique

41. PARKINSON’S DISEASE Lingualized occlusal scheme Implant supported denture Magnet supported denture Neutral zone technique.

42. REFERENCE: Jefrey Okeson management of temporomandibular disorders and occlusion Abarna Shivani S,Leoney A. Neuromuscular Disorders and Prosthodontic Strategies in Complete Denture Patients Gupta S, Dhawan P. Prosthodontic rehabilitation of completely edentulous patients with resorbed mandibular ridge: case series

43. THANK YOU