Craniomandibular muscles : their role in function and form

288 Pages·2017·8.62 MB·English

by  Miller, Arthur J

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ISBN 978-1-138-55061-2
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www.crcpress.com
Craniomandibular
Muscles:
Their Role
in
Function
and
Form
Author
Arthur J. Miller, Ph.D.
Professor
Department of Growth and Development
University of California at San Francisco
San Francisco, California
and
Department of Physiology
School of Medicine
University of California at San Francisco
San Francisco, California
First published 1991 by CRC Press
Taylor & Francis Group
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Reissued 2018 by CRC Press
© 1991 by Taylor & Francis
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PREFACE
This book was written with the intent to bring some of the concepts and challenges to the
reader regarding the continually changing field of oral biology as related to craniomandibu-
lar muscles. The function of these muscles, which envelopes the cranioskeleton and mandible,
provides the basic premise of dental treatment and the fundamental understanding of how the
cranioskeleton grows and develops. The relevance of the craniomandibular muscles to occlu­
sion, how occlusion and the temporomandibular joints interact, and their implications to long­
term cranioskeletal development permeate the topics recorded within the dental literature.
Changing concepts in temporomandibular disorders and the potential causes of muscle pain
focus considerable basic and clinical science attention on these muscles. The broad interest in
these muscles from numerous subdisciplines of dentistry and the medical field means that the
investigative work produced over this century, and particularly since World War II, needs to
be integrated with some perspective.
The book has been designed to cover as much information as possible about craniomandi­
bular muscles so that the cellular, anatomical, histochemical, physiological, and pathological
aspects of these muscles can be brought together. However, while much of the book summa­
rizes the research of others and our laboratory, the reader needs to use this book as the starting
point to review and read the original articles. The book is written so as to encapsulate the main
information from an individual study, but the viewpoint of the individual investigator needs
to reach the reader. The material is presented from a perspective in an attempt to integrate the
subject matter in the respective fields in the hope that future investigators and scientists and
present students of the field will find this field as exciting as it is to the author.
THE AUTHOR
Arthur J. Miller, Ph.D., is a professor in the Department of Growth and Development,
School of Dentistry and professor in the Department of Physiology, School of Medicine at the
University of California, San Francisco, California. He holds joint appointments in the
graduate group of the Oral Biology Advanced Degree Program in the Department of Stoma­
tology and is a member of the Center for Temporomandibular Disorders and Orofacial Pain
in the Department of Restorative Dentistry.
Dr. Miller was graduated from the University of California, Los Angeles in 1970, with a
doctoral degree in physiology and simultaneously served as a United States Public Health
Predoctoral Trainee at the Brain Research Institute. He served as an Assistant Professor in the
Department of Physiology at the University of Illinois Medical School, Chicago from 1970
to 1975, Adjunct Assistant Professor and Associate Professor at the University of California,
San Francisco from 1975 to 1984. He assumed his present position in 1984.
Dr. Miller has been a member of the International Association for Dental Research, the
American Association for Dental Research, the Neuroscience Society, the American Physio­
logical Society, the International Brain Research Organization, the Federation of Experimen­
tal Biologists, the New York Academy of Sciences, and the Federation of American Scientists.
He is an honorary member of the National Dental Honor Society, Omicron Kappa Upsilon.
He serves on the editorial boards of the journals Dysphagia and the American Cleft Palate
Journal and as a consultant to several international and national journals, the National
Institutes of Health, the National Science Foundation, and the Medical Research Council in
Canada.
Dr. Miller has published over 55 original research papers and chapters and has served as
invited lecturer and presenter to both international and national meetings. He has been the
recipient of several grants from the National Institutes of Dental Research and the National
Institutes of Child Health and Human Development. His current research interests include the
interrelationship of craniomandibular muscle function with cranioskeletal growth and devel­
opment and the relationship of muscle function to temporomandibular disorders.
DEDICATION
Each of us cherish those special people who have rendered more than we could ever return
and who, through their friendship, expertise, guidance, and commitment, provides that impor­
tant ingredient of support. This book is dedicated to two people, one in my professional life
and one in my personal life. The first is Dr. Jennifer Buchwald, my mentor at UCLA and
faithful supporter when I entered the scientific field in earnest to seek a doctorate. She has
always exhibited the qualities of a first-rate and superior scientist, and the experiences in her
laboratory and under her guidance will be remembered. The second individual is my wife of
25 years and companion of numerous prenuptial years who has been the closest friend and the
most endearing of my close friends. Without her, life doesn’t exist, and, without her, this book
would not have been completed. Her love, and that of my three superb children, Garreth,
Ashleigh, and Heath, have been the finest support.
ACKNOWLEDGMENTS
It is the support and encouragement of friends and family that have provided much of
the impetus for completing this work, and I sincerely appreciate the editorial comments of
Dr. Richard Flower and my wife, Marilyn Loushin-Miller.
TABLE OF CONTENTS
Chapter 1
Craniomandibular Muscle Anatomy .......................................................................................1
I. Introduction............................................................................................................................1
II. Craniomandibular Muscles as Skeletal Muscles...............................................................1
A. Cellular Definition......................................................................................................1
B. Sarcomere as Functional Unit...................................................................................2
III. Anatomy of the Human Craniomandibular Muscles.......................................................4
A. Definition.....................................................................................................................4
B. Temporalis Muscle.....................................................................................................4
C. Masseter Muscle.........................................................................................................5
D. Medial Pterygoid Muscle...........................................................................................5
E. Lateral Pterygoid Muscles..........................................................................................5
F. Digastric Muscle.........................................................................................................6
IV. Biomechanics of Muscle Contraction...............................................................................6
A. Principles of Function...............................................................................................6
B. Vectors and Torque....................................................................................................6
C. Mechanical Advantage..............................................................................................9
D. Three Dimensional Biomechanical Analysis........................................................10
E. Computer Models of Force Development.............................................................12
V. Adaptation of Craniomandibular Muscles with Growth................................................15
VI. Summary.............................................................................................................................15
References......................................................................................................................................16
Chapter 2
Muscle Fiber Characteristics ..................................................................................................19
I. Introduction.........................................................................................................................19
II. Defining Muscle Fibers by Histochemistry....................................................................19
A. Defining Muscle Fiber Types.................................................................................19
B. Defining Muscle Fibers by Immunochemistry.....................................................20
C. Jaw-Closing Muscles in Human............................................................................20
D. Jaw-Closing Muscles in Rhesus Monkey.............................................................22
E. Lateral Pterygoid Muscle in Human......................................................................29
F. Digastric Muscle in Human...................................................................................29
G. Digastric Muscle in Rhesus Monkey.....................................................................29
III. Adaptations in Muscle Fiber Types................................................................................29
A. Abnormal Vertical Dimension in the Human.......................................................29
B. Altering the Mandibular Posture in the Rhesus Monkey....................................30
C. Dentures and Edentulous Condition in the Human.............................................31
D. Chronic Edentulous Condition in the Rhesus Monkey.......................................31
E. Muscle Detachment in the Rhesus Monkey.........................................................32
F. Altering Muscle Length in the Rhesus Monkey..................................................32
G. Muscle Activity and Histochemical Composition in the
Rhesus Monkey........................................................................................................33
H. Onset of Function and Postnatal Development....................................................35
I. Regeneration and Myosin Gene Expression.........................................................36
IV. Significance and Implications............................................................................................36
A. Relation of Histochemical Properties to Physiological
Parameters..................................................................................................................36
B. Conditions for Changing Composition of Muscle Fiber
Types .........................................................................................................................37
V. Magnetic Resonance Spectroscopy..................................................................................38
VI. Summary.............................................................................................................................40
References......................................................................................................................................41
Chapter 3
Electromyography......................................................................................................................45
I. Introduction.........................................................................................................................45
II. Innervation of the Craniomandibular Muscles................................................................45
III. Electromyography of Craniomandibular Muscles..........................................................46
A. Definition of Electromyography.............................................................................46
B. EMG Recordings Related to Muscle Fibers.........................................................47
IV. Muscle Tension...................................................................................................................49
A. Muscle Tension as Related to Sarcomere Length................................................49
B. Muscle Tension as Related to EMG......................................................................52
C. Bite Force and Relation to Muscle Force..............................................................55
V. Objective Analysis of the Electromyogram....................................................................58
A. Rectification and Integration...................................................................................58
B. Power Spectral Analysis.........................................................................................58
VI. Evoked Potentials with Central Stimulation...................................................................60
VII. Summary..............................................................................................................................62
References......................................................................................................................................66
Chapter 4
Mandibular Rest Position ........................................................................................................71
I. Introduction.........................................................................................................................71
II. Defining Mandibular Rest Position..................................................................................72
A. Definition of Rest Position......................................................................................72
B. Mandibular Incisor Tracking...................................................................................72
C. Contribution of Passive Forces...............................................................................72
D. Contribution of Active Forces: Changing Head Position ....................................73
E. Contribution of Active Forces: Changing Visual Input........................................74
F. Contribution of Active Forces: Various Mandibular Muscles............................75
G. Relevance of Proprioceptive Input.........................................................................76
III. Summary.............................................................................................................................77
References......................................................................................................................................77
Chapter 5
Mandibular Muscle Function and Recruitment ..................................................................79
I. Introduction.........................................................................................................................79
II. Individual Craniomandibular Muscles .............................................................................79
A. Value of Electromyographic Assessment..............................................................79
B. Temporalis Muscle Function...................................................................................80
C. Masseter Muscle Function......................................................................................87
D. Medial Pterygoid Muscle Function........................................................................88
E. Lateral Pterygoid Muscle Function........................................................................89
F. Digastric Muscle Function......................................................................................93
III. Coactivation in Craniomandibular Muscle Function.....................................................94
A. Clenching...................................................................................................................95
B. Wide Opening...........................................................................................................96
C. Laterotrusion.............................................................................................................97
D. Protrusion.................................................................................................................100
E. Retrusion..................................................................................................................102
IV. Onset of Muscle Function...............................................................................................103
V. EMG with Deciduous Dentition.....................................................................................105
VI. Fatigue and Craniomandibular Muscle Function..........................................................105
VII. Summary............................................................................................................................106
References....................................................................................................................................108
Chapter 6
Mastication and Deglutition ..................................................................................................Ill
I. Introduction......................................................................................................................Ill
II. Mastication........................................................................................................................112
A. Mandibular Movement in Mastication.................................................................112
B. Mandibular Muscle Activity.................................................................................114
C. Central Neural Control of Mastication................................................................119
D. Relevance of Peripheral Sensory Input................................................................120
III. Deglutition.........................................................................................................................122
A. Oral and Pharyngeal Phases..................................................................................122
B. Esophageal Phase...................................................................................................123
IV. Summary...........................................................................................................................123
References....................................................................................................................................124
Chapter 7
Crandiomandibular Muscle Sensory Input .........................................................................131
I. Introduction.......................................................................................................................131
II. Proprioceptors...................................................................................................................132
A. Muscle Spindle.......................................................................................................134
B. Masseteric Reflex...................................................................................................135
C. Joint Proprioception...............................................................................................137
D. Mandibular Kinesthesia.........................................................................................139
E. Mandibular Kinesthesia and Craniomandibular Disorders................................142
III. Other Mechanoreceptors..................................................................................................144
A. Complex Reflex Response-Silent Period.............................................................144
B. Complex Reflex in Subjects with Craniomandibular
Disorders..................................................................................................................154
C. Jaw-Opening Reflex...............................................................................................155
IV. Summary...........................................................................................................................155
References....................................................................................................................................156
Chapter 8
Relation Between Occlusion and Muscle Recruitment ....................................................161
I. Introduction.......................................................................................................................161
II. Effect of Occlusal Contacts.............................................................................................162
A. Number and Type of Occlusal Contacts..............................................................162
B. Recruitment of Mandibular Muscles...................................................................163
III. Dual Bite...........................................................................................................................169
IV. Cross Bite..........................................................................................................................170
V. Functional Appliances and Craniomandibular Muscle Function................................173
VI. Effect of Malocclusions on Muscle Function...............................................................174
VII. Dentures, Muscle Recruitment and Force.....................................................................176
VIII. Relevance of Occlusion and Morphology to Craniomandibular
Muscle Function................................................................................................................176
IX. Summary............................................................................................................................178
References....................................................................................................................................179
Chapter 9
Mandibular Muscle Pain and Craniomandibular Muscle Function ............................181
I. Introduction.......................................................................................................................181
II. Subjects with Muscle Pain...............................................................................................182
A. Resting Muscle Activity........................................................................................182
B. Masticatory Muscle Activity..................................................................................186
C. Effect of Sustained Muscle Activity....................................................................189
D. Muscle Fatigue.......................................................................................................189
E. Bite Force in Subjects with Muscle Pain............................................................189
F. Muscle Function as Related to the Temporomandibular
Joint...........................................................................................................................191
G. Relevance of Craniomandibular Muscle Function to
Muscle Pain.............................................................................................................191
III. Bruxism and Craniomandibular Muscles......................................................................193
A. Bruxism and Symptoms.........................................................................................193
B. Frequency of Occurrence......................................................................................194
C. Bruxism as Related to Direction and Level of Muscle Force...........................194
IV. Occlusal Splint..................................................................................................................195
A. Effect of Occlusal Splint in Normal Subjects....................................................195
B. Effect of Occlusal Splint in Subjects with Muscle Pain...................................196
V. Occlusion and Craniomandibular Muscle Interaction..................................................196
VI. Headaches and Craniomandibular Muscles...................................................................199
VII. Summary...........................................................................................................................202
References....................................................................................................................................203
Chapter 10
Craniomandibular Muscle Function and Morphology ...................................................207
I. Introduction.......................................................................................................................207
II. Effect of Impairing or Eliminating the Neuromuscular System.................................208
A. Effect of Removal of One Mandibular Muscle..................................................208
B. Effect of Removing Several Muscles..................................................................209
C. Interpretation of the Muscle Deletion and Impairment
Studies......................................................................................................................214
III. Human Morphology and Muscle Recruitment..............................................................216
A. Cephalometric Measurements and Muscle Activity..........................................216
B. Craniomandibular Form and Muscle Area.........................................................216
C. Change in Muscle Function and Cranioskeletal Morphology..........................217
IV. Primate Morphology and Craniomandibular Muscles.................................................218
A. Muscle Recruitment as Related to Bone Strain..................................................218
B. Altering Mandibular Position: Clockwise Rotation and
Opening....................................................................................................................224