kuliah ppdgs - mastikasi
TRANSCRIPT
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A dynamic biomechanical musculoskeletal system
The Masticatory Systemby Widyawati Sutedjo
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Maxilla
Mandible
Condyle
Ascending Ramus
Coronoid Process
Body of the mandible
Temporal bone
Skeletal Anatomy:Masticatory System
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Mastication
Mastication:
Processes involved in food preparation,
including moving unchewed food onto thegrinding surface of the teeth, chewing, it, and
mixing it with saliva in preparation for
swallowing
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Loss of Teeth CausesOcclusal Disharmony
Early loss of deciduous teeth withoutspace retaining appliances
Loss of mandibular first molar
l ingual and mesial tipping of mandibular 2nd and 3rd
molar
Loss vertical dimension Changing in masticatory habit and muscle tonicity
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Signs of occlusal disorders
Repeated fracture of teeth or restorations.
Repeated lossofcementationof indirect restorations whereretention and resistance in the preparation appear adequate.
Driftingor progressively increasingmobilityof a tooth orgroups of teeth.
Wearofthe functionalsurfacesof the teeth, which is out ofproportion to the patients age.
Signand symptomsfrom TMDor their associated muscles.
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OCCLUSAL THERAPY
The purpose of occlusal therapy is to establishstable functional relationships favorable to theoral health of the patient, including the
periodontium
Occlusal Adjustment
Occlusal adjustment, or coronoplasty, is the selectivereshaping of occlusal surfaces with the goal ofestablishing a stable, nontraumatic occlusion
have been used extensively in the past for treating avariety of problems including occlusal trauma, TMD
symptoms, bruxism, and headache
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Kriteria fungsi oklusi yang baik
Pengunyahan bilateral yang seimbang dan bergantian. Kontak ringan pada posisi interkuspa ketika menelan Gerak mengunyah kedalam dan keluar, yang bebas dari
kontak defleksi pada sisi kerja maupun non-kerja Tidak ada gerak adaptasi dagu atau bibir pada saat
menelan Tidak ada gerak mengerot (clenching) dan bruxism Tidak ada bunyi sendi pada saat mastikasi maupun
membuka mulut lebar-lebar
Tidak ada deviasi mandibula waktu mulut dibuka lebar Tidak ada kontak gigi pada saat berbicara atau
melakukan ekspresi wajah
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Centric Relation
Centric Relation is anorthopedically stable muscularposition where the condyle rests
in a superior anterior positionagainst the posterior wall of thearticular eminence with thearticular disk interposed.
A purely rotational movementcan occur for the first 20-25 mm
of jaw opening.
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Centric Occlusion vs.Maximum Intercuspation
Centric Occlusion is thetooth position when theTMJ is in CR and the
teeth first touch onclosing. Maximum intercuspation
is the position of theteeth when there ismaximum contact ofteeth in occlusion.
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Mandibular Movement
Mandibular movements occurs as acomplex series of interrelated three-dimensional rotational and translationalactivities.
It is determined by the combined andsimultaneous activities of
temporomandibular joints (TMJs). There are two types of movement occurs
in the TMJ: rotational and translational.
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Types of Mandibular Movement Rotational movement
Horizontal axis of rotationFrontal (vertical) axis of
rotationSagittal axis of rotation
Translational movement
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Rotational Movement Around the horizontal axis (hinge
axis)
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Rotational Movement Around the frontal
(vertical axis
Occurs when onecondyle movesanteriorly out of theterminal hinge position
with the vertical axisof the oppositecondyle remaining inthe terminal hinge
position
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Rotational Movement Around the
sagittal axis
Occurs whenone condylemoves inferiorlywhile the other
remains in theterminal hingeposition.
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Translational movement Can be defined
as a movement
in which everypoint of themoving objecthas
simultaneouslythe samevelocity anddirection.
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Anatomical Planes ofMandibular Movement
Frontal view Front view of
the jaws
Sagittal view Lateral view of
the jaws
Horizontal view Superior view
of the jaws
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Border Movements
Mandibular movement islimited by the ligaments,muscles of the TMJ,
articular surfaces andmorphology andalignment of teeth.
The outer limitsof themandibles range ofmotion are called bordermovements.
Gothic Arch Tracing
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BORDER AND FUNCTIONALMOVEMENTS (SAGITTAL PLANE)
**Movement is limited by ligaments
1
2
3
4
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BORDER MOVEMENTSSAGITTAL PLANE (Gothic Arch Tracing)
Posterior opening stage one - early rotational
movement around the horizontal axis.
Rotationalmovement of themandibular withthe condyles inthe terminal hingeposition.
This purerotational openingcan occur until theanterior teeth are20-25 mm apart.
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Second stage of rotationalmovement during opening.
The condyle is translateddown the articulareminence while the mouthrotates open to itsmaximum limit.
Maximum opening isreached when the capsularligament prevent furthermovement of the condyles.
Posterior opening stage two-
translational down theeminence.
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With the mandiblemaximally opened,closureaccompanied bycontraction of theinferior lateralpterygoids will
generate theanterior openingbordermovements.
Anterior opening in
sagittal plane
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BORDER MOVEMENTSSAGITTAL PLANE
Common relationship of theteeth when the condyles
are in the centric relation
(CR) position.
Force applied to the teethwhen the condyles are incentric relation (CR) willcreate a superoanteriorshift of the mandible tothe intercuspal position
(ICP).
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When mandibular movements are viewed inthe horizontal plane, a rhomboid-shapedpattern can be seen, as well as 4 distinctmovement components.
1. Left lateral2. Continued left lateral
with protrusion3. Right lateral4. Continued Right lateral
with protrusion
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BORDER MOVEMENTSHORIZONTAL PLANE
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FRONTAL PLANE BORDERMOVEMENTS
(Shield Shape)
** Note:Thered Dot=Postural Position
= Rest Position
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TMJ Ligaments
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Ligaments
Temporomandibular
ligament
extend from base of zygomatic
process of the temporal bone
downward and oblique to the
neck of the condyle
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Ligaments
Stylomandibular
ligament
From styloid process and
runs downward and
forward to attach broadly
on the inner aspect of theangle of mandible
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Ligaments
Sphenomandibular
ligament
arising from the angular
spine of sphenoid bone and
petrotympanic fissure,
ending at lingula ofmandible
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Functions of Ligaments
Accessory ligaments may limit
border movements of the
mandible
Fibrous capsule and TM ligament
may limit of extreme lateralmovements in wide opening of
mandible
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