Alya Putri Khairani /

130110110220 / C1

Physiology of Mastication and Deglutition

Mastication
DEFINITION
he masticatory system is a functional unit composed of the teeth; their supporting structures,
the Mandibula; the Temporomandibular joints; the muscles involved directly or indirectly in
mastication (including the muscles of the lips and tongue); the cheeks, the palate, and the
salivary secretions and the vascular and nervous systems supplying these tissues. Mastication
itself is the action of breaking down of food, preparatory to deglutition. This breaking-down action is
highly organized complex of neuromuscular and digestive activities that, in normal individuals,
integrate the various components of the masticatory system.

There are several factors determining the chewing result. The teeth are important in the masticatory
system. They form the occlusal area where the food particles are fragmented. This fragmentation
depends on the total occlusal area and thus on the number of teeth. Another important factor
in mastication is the bite force. The bite force depends on muscle volume, jaw muscle activity,
and the coordination between the various chewing muscles. Also the movement of the jaw,
and thus the neuromuscular control of chewing, plays an important role in the fragmentation of the
food. Another aspect of chewing is how well the tongue and cheeks manipulate the food particles
between the teeth. Finally, the production of sufficient saliva is indispensable for good chewing
STRUCTURES
The most important muscles that form the bite form and jaw movement are:
Temporal (anterior and posterior)
Masseter (superficial and deep)
Medial Pterygoid
Lateral Pterygoid (superior and inferior)
The Trigeminal Motor nucleus of motoneurons innervating the jaw muscles lies across the midline of the
brainstem. However, mastication involves far more muscles than these "muscles of mastication"
innervated by the Trigeminal Nerve (CN V).
Actions of muscles during masticatory movements are:
Opening/Depressor jaw muscle:
Consist of Inferior Lateral Pterygoid, Mylohyoid, Geniohyoid, and Anterior Digastric muscle
Closing/Elevator jaw muscle:
Consist of Medial Pterygoid, Superficial Masseter, and Tempolaris muscle

Digastric
us
Geniohyo
id

Alya Putri Khairani /

130110110220 / C1
Extrinsic muscles of the tongue are also have a
role in the masticatory system. Innervated by
Hypoglossal nerve (CN XII), tongue is
important in jaw movements and respiration,
speech, taste, mastication, swallowing, and
sucking.
NEUROLOGICAL CONTROL
To create precise mandibular movements, inputs from
various sensory receptors must be received by the central
nervous system through afferent nerve fibers. The
brain assimilates and organizes these inputs and elicits
appropriate motor activities through the efferent nerve
fibers. These motor activities involve the contraction of
some muscle groups and the inhibition of others. Chewing
is a subconscious activity, yet can be brought to
conscious control at any time
The coordination and rhythmicity of mastication has been attributed to the alternate activation of two
simple Brain Stem reflexes. These are the Jaw Opening Reflex, activated by tooth pressure or tactile
stimulation of wide areas of the mouth and lips, and the Jaw Closing Reflex, which follows stretching
of the elevator muscles during opening. The introduction of a food bolus into the mouth was thought to
initiate a self-perpetuating cycle by producing jaw opening, and the consequent stretching of the
elevator muscles would produce jaw closure on the bolus, again producing jaw opening by stimulation
of Periodontal and soft tissue receptors.
The control of mastication is dependent in large part on sensory feedback, which consists of Epithelial
Mechanoreceptor afferents, Periodontal afferents, Temporomandibular Joint afferents and
Muscle afferents. Sensory feedback may explain the coordination of the tongue, lips, and jaws to
move the food around, the reason why different foodstuffs influence the pattern of masticatory
movement, or the abrupt changes from cycle to cycle. While the Cortex is the main determiner of
action, centers in the Brain-Stem maintain homeostasis and control normally subconscious body
functions
Within the brain-stem is a pool of neurons - a central pattern generator (CPG) - that controls rhythmic
muscle activities. It is responsible for the precise timing of activity between synergetic and antagonistic
muscles, so that specific functions can be carried out. Sensory feedback interact with the control
system at several levels to adapt the rhythmic program to characteristics of the food. This feedback is
also a source of the variability in masticatory movements. Once an efficient chewing pattern is found, it
is learned and repeated. This learned pattern is called a Muscle Engram. Chewing therefore can be
thought of as an extremely complex reflex activity.
NORMAL MASTICATORY MOVEMENT
Chewing must be learned, and occurs only after tooth eruption. Chewing becomes well coordinated
around 4-5 years of age, by which time the primary teeth have erupted. Different investigations have
shown that the pattern of masticatory movements varies considerably from one individual to another.
Chewing consists of 3 steps:
Opening Stage
The masticatory envelope is usually described as a "tear-drop shape" with a slight displacement at the
beginning of the opening phase. This means that the opening movement rarely goes straight down. In
most cases it deviates to the chewing side. When a subject deliberately chews on the right side, the jaw
follows a cyclic pathway is a clockwise direction, and chewing on the left side is associated with
movement in a counterclockwise direction.
(1) Start from static Intercuspal position
(2) Early in the opening phase, Digastric muscles become
active and remain until maximum opening position
(3) Muscle activity begins in the Inferior head of the
Lateral Pterygoid muscle approximately half way
through the period of tooth contact
(4) During the opening phase, Masseter, Temporalis,
Medial Pterygoid, and superior head of Lateral
Closing Stage
At initiation of jaw closing the inferior heads of the Lateral Pterygoid muscle ceases their functioning
and activity initiated in the contralateral Medial Pterygoid muscle. Contralateral Medial Pterygoid
controls the upward and lateral positions of the mandible
(1) The ipsilateral and contralateral medial pterygoid muscles are active

Alya Putri Khairani /

130110110220 / C1
(2) Activity increases in the Anterior and Posterior Temporalis muscle, in the deep and superficial
Masseter muscles, and in the Ipsilateral Medial Pterygoid muscle up to the peak 20 to 30 ms
before the onset of the intercuspal position
(3) Anterior and posterior Temporalis muscle, in the deep and superficial Masseter muscles, and in
the Ipsilateral Medial Pterygoid muscle activity declines in activity at the onset of intercuspation
Intercuspation Stage
Tooth to tooth contact occurs. Part of mandibular closure determined by slide of mandibular teeth along
with the cuspal inclines of the maxillary teeth. In vertical affort, most of the elevator muscles that
activated maximally will form clenching in centric occlusion

Deglutition
Deglutition (swallowing) is the complex process that transfers a food bolus from the mouth through the
pharynx and esophagus into the stomach. Solid food is masticated (chewed) and mixed with saliva to
form a soft bolus that is easier to swallow. Deglutition occurs in three stages:

A. The bolus of food is squeezed to the back of the mouth by pushing the tongue against the palate. B. The
nasopharynx is sealed off and the larynx is elevated, enlarging the pharynx to receive food. C. The
pharyngeal sphincters contract sequentially, squeezing food into the esophagus. The epiglottis deflects the
bolus from but does not close the inlet to the larynx and trachea. D. The bolus of food moves down the
esophagus by peristaltic contractions

Stage 1: Voluntary; the bolus is compressed against the palate and pushed from the mouth
into the oropharynx, mainly by movements of the muscles of the tongue and soft palate (Fig.
8.45A & B).
Stage 2: Involuntary and rapid; the soft palate is elevated, sealing off the nasopharynx from
the oropharynx and laryngopharynx (Fig. 8.45C). The pharynx widens and shortens to receive
the bolus of food as the suprahyoid muscles and longitudinal pharyngeal muscles contract,
elevating the larynx.
Stage 3: Involuntary; sequential contraction of all three pharyngeal constrictor muscles forces
the food bolus inferiorly into the esophagus

References:
Moore Clinically Oriented Anatomy 6th edition
http://www.sbdmj.com/053/053-03.pdf
http://www.dent.cmu.ac.th/thai/diag/elearning/masticatio
n47.ppt