Muscles of

Mastication

BY : DR. ROLAND CUTINHO

MDS 1ST YEAR
DEPARTMENT OF PROSTHODONTICS, CROWN &
BRIDGE AND IMPLANTOLOGY
RISHIRAJ COLLEGE OF DENTAL SCIENCE AND
RESEARCH CENTRE
 Contents
 Introduction
 Definitions
 Development
 Classification
 Primary muscles
 Accessory muscles
 Mandibular movements and role played by muscles
 Masticatory muscle disorders
Conclusion
 Reference
 Introduction

The muscles of mastication are a group of muscles responsible for the

chewing movement of the mandible at the temporomandibular joint (TMJ),
they enhance the process of eating, they assist in grinding food, and also
function to approximate the teeth.

Food is the main source of energy this energy is derived through the complicated
process of digestion. 1st step of digestion is mastication.
Rhythmic movements of jaws with the involvement of teeth, lips ,cheeks and tongue for
chewing of food in order to prepare it for swallowing and digestion.

 Main purpose of mastication is to reduce the size of food particles to a size that is
convenient for swallowing (bolus formation) with the help of saliva.

Muscles of mastication are the group of muscles that help in movement of the mandible
as during chewing and speech. We need to study these muscles as they control the
opening & closing the mouth & their role in the equilibrium created within the mouth.
They also play a role in the configuration of face.

These muscles along with accessory ones together are termed as “MUSCLES OF
MASTICATION” Influence of these muscles in prosthetic dentistry, defines the borders
& peripheral extensions.
 Definitions
As per GPT 10
 MUSCLE:
An organ that by contraction produces movements of an animal; a tissue
composed of contractile cells or fibers that effect movement of an organ or
part of the body.

 MASTICATION
Is defined as the process of chewing food in preparation for swallowing
and digestion.
• The four main muscles of
mastication originate from the
surface of the skull and they
attach onto the ramus of the
mandible.
• The muscles of mastication are
innervated by motor branches
of the mandibular division of
the trigeminal nerve (CNV3),
while the main arterial supply
is derived from branches of the
maxillary artery
Muscles of Masseter
Mastication Primary
can be Muscles Temporalis
divided into Medial Pterygoid

Lateral Pterygoid

Buccinator
Secondary
or Suprahyoid
Digastric

Mylohyoid

Accessory Muscles Geniohyoid

Sternohyoid
Infrahyoid
Muscles Muscles
Sternothyroid
Thyrohyoid
Omohyoid
 FUNCTIONALLY CLASSIFIED AS

JAW ELEVATORS JAW DEPRESSORS

 Masseter  Lower head of lateral pterygoid
 Temporalis  Anterior digastric
 Medial pterygoid  Geniohyoid
 Upper head of lateral pterygoid  Mylohyoid
Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 3 rd ed. 2001
 Development
• All the muscles of mastication develop from the
mesoderm of 1st brachial arch (mandibular
arch), therefore, they are supplied by
mandibular nerve.

• Accessory muscles:-
• Digastric - 1st & 2nd ARCH

• Mylohyoid - 1st ARCH

• Geniohyoid - Upper cervical somites

• Buccinator - 2nd ARCH

The muscular system develops from intra embryonic mesoderm
from embryonic cells called myoblast.
 Muscles of mastication are derived from first brachial arch that
is mandibular arch.

 5th- 6th week

 Primitive cells form and differentiate
 Get oriented to site of origin and insertion

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
7th week
• Mandibular arch mass enlarge.
• Cell migrate to areas of formation of 4 major muscles of mastication.
• Cell differentiation occurs before formation of facial arch.

10th week
• Muscle mass well organized .
• Nerve masses get incorporated

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
 Masseter

• Name comes from Greek word “maseter”-

which means a chewer.
• This is a quadrilateral muscle, partly
tendinous, partly fleshy which covers the
lateral part of ramus of mandible.
• It consists of three layers that blend
anteriorly:
• Superficial layer
• Intermediate layer
• Deep layer
Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
 Masseter
ORIGIN INSERTION

SUPERFICIAL LAYER • Anterior 2/3 of lower Lower part of lateral surface

(Largest) border of zygomatic arch of ramus of mandible
• Adjoining zygomatic
process of maxilla

MIDDLE LAYER Lower border of posterior Central part of ramus of

1/3 of zygomatic arch mandible

DEEP LAYER Deep surface of zygomatic Rest of the ramus of

arch mandible

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
. .
 Masseter

Nerve Supply
• Supplied by Masseteric nerve, a branch of
anterior division of mandibular nerve

Blood supply
• Supplied by masseteric artery branch of
maxillary artery
• Venous drainage through masseteric
vein

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
ACTIONS:
o Elevation of the mandible.
o Protraction of mandible (by superficial fibers).
o Retraction of mandible (by deep fibers).
o Activity in resting position is minimal
 Palpation of
Muscle
To perform an extraoral
examination, stand near the patient
and visually inspect and bilaterally
palpate the muscle. Place the
fingers of each hand over the
muscle and ask the patient to
clench his or her teeth several
times.

Palpate the origin of the masseter

bilaterally along the zygomatic
arch and continue to palpate
down the body of the mandible
where the masseter is attached. Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 Prosthodontic
Consideration
• When the Masseter is activated it pushes
the Buccinator medially and superiorly
against the denture border in the area of
retromolar pad.
• This is a dislodging force and the denture
base should be contoured to accommodate
this action.
• This contour of the denture base is termed
the Masseteric notch.
• To record masseteric groove, instruct the
patient close mouth against resisting force
of finger.

Ref: Charles M. Heartwell Jr., Arthur O.Rahn’s Syllabus of complete dentures. 4 th edition. 1992
 On Denture Border
• An active masseter muscle will create a concavity in the outline of the distobuccal border and a
less active muscle may result in a convex border.

• In this area the buccal flange must converge medially to avoid displacement due to contraction
of the masseter muscle because the muscle fibers in that area are vertical and oblique.

Ref: Charles M. Heartwell Jr., Arthur O.Rahn’s Syllabus of complete dentures. 4th edition. 1992
EFFECT OF MASSETER MUSCLE
ON THE DISTOBUCCAL BORDER
A. Moderate activity will create a straight line
B. An active muscle will create a concavity.
C. An inactive muscle will create a convexity.
 Temporalis
⮚ It is a fan-shaped muscle that fills the temporal fossa,
with anterior fibres that have a vertical orientation, mid
fibres have an oblique orientation, and posterior fibres
have more of a horizontal orientation.
⮚ ORIGIN
⮚ Divided into anterior, middle and posterior temporal
• Temporal fossa excluding zygomatic bone
• Temporal fascia
⮚ INSERTION
• Margins and deep surface of coronoid process
• Anterior border of ramus of mandible

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
. .
 Nerve Supply
It is supplied by the
deep temporal nerve which is a
branch from the anterior
division of the mandibular
nerve.

Blood Supply
It is supplied by the
deep temporal part of the
maxillary artery and the
middle temporal branches of
the superficial temporal artery.

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
 ACTIONS:
∙ Elevate the mandible (anterior and middle fibres)
Temporalis ∙ Retract the mandible, side to side grinding
movement (posterior fibres)
Posterior fibers draw the mandible backwards
after it has been protruded .
 Temporalis muscle can be seen and
Palpation of readily palpated through entire length and
Muscle breadth when the patient’s teeth are
clenched.

Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 The muscle is divided into three functional areas and
therefore each area is independently palpated.

To locate the muscle, have the patient clench.

The anterior region is palpated above the zygomatic arch

and anterior to the TMJ.

The middle region is palpated directly above the TMJ and

superior to the zygomatic arch.

The posterior region is palpated above and behind the ear.

Prosthodontic
Consideration
• It acts as a stabilizer of TMJ.
During protrusion,
posterior fibers are
aligned more
horizontally.
• Temporalis suspends the
mandible in rest position.
• Anterior group of fibers which
are aligned vertically hold the
mandible in superior most
position.
Sudden contraction of temporalis muscle will result in
coronoid fracture, which is rare.

The patient is instructed to close and move his mandible

from side to side and then immediately asked to open wide.

The side to side motion records the activity of the coronoid

process in a closed position whereas opening causes the
coronoid to sweep past the denture periphery.

Ref: Charles M. Heartwell Jr., Arthur O.Rahn’s Syllabus of complete dentures. 4th edition. 1992
 • The medial pterygoid muscle (internal pterygoid
muscle) is a thick quadrilateral muscle with a
Medial Pterygoid superficial head and a deep head.
• The deep head of the medial pterygoid is
larger than the superficial head.
ORIGIN INSERTION

SUPERFICIAL Tuberosity of Roughened area on the

HEAD maxilla and medial surface of angle
(Smaller) adjoining bone and adjoining ramus of
mandible, below and
• Medial surface of behind mandibular
DEEP HEAD
lateral pterygoid foramen and mylohyoid
(Larger) groove
plate
• Adjoining
process of palatine
bone
 Nerve supply
• It is innervated by the branch of the main trunk of the
mandibular nerve.
Blood Supply
• Its is supplied by a pterygoid branch of 2nd part of the
maxillary artery
• Venous drainage is by the lingual vein
Actions:
• Elevation of mandible.
• Protrusion of mandible (along with lateral pterygoid).
• Protrusion of side of jaws by acting alone
• Side to side movements of mandible (chewing)
(lateral and medial pterygoid muscles of two sides
contract alternately).
Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
 Palpation of Muscle

Gently palpate them on the medial

aspect of the jaw, simultaneously from
both inside and outside the mouth

• The muscle contracts as the teeth are

coming in contact.
• Also stretches when the mouth is open
wide.

Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 Prosthodontic Consideration

• When the medial & lateral pterygoid’s

of opposite side act together, the
corresponding side of mandible is
rotated forwards to the opposite side,
with the opposite mandibular head as
a vertical axis.
• Alternating activity in the left & right
sets of muscles produces side-to-
side movements, which are used to
triturate food.

Ref: Charles M. Heartwell Jr., Arthur O.Rahn’s Syllabus of complete dentures. 4th edition. 1992
Most commonly involved in MPDS .

Trismus following inferior alveolar nerve block is mostly due to

involvement of medial pterygoid muscle.

The medial pterygoid muscle is not usually involved in gnathic

dysfunctions but when they are hypertonic, the patient is usually
conscious of a feeling of fullness in the throat and an occasionally
pain on swallowing.

Ref: Raymond J.Fonseca’s Oral and Maxillofacial Surgery, 2nd Edition, 2008.
 • It is a short thick conical muscle with definite upper and lower
heads

Lateral Pterygoid • Key muscle of infratemporal region, also called as external

pterygoid muscle.
• Origin is medial to insertion which is posterolateral and at a slightly
higher than origin

ORIGIN INSERTION

UPPER Infratemporal • Pterygoid fovea

HEAD surface and on anterior
(Smalle crest of greater surface of neck
r) wing of of mandible
sphenoid • Anterior margin
of articular disk
LOWER Lateral surface • Capsule of TMJ
HEAD of lateral
(Larger) pterygoid plate

Ref: B.D. Chaurasia’s Human Anatomy Regional and Applied Dissection and Clinical. 9th ed. 2023
 Lateral Pterygoid

NERVE • A branch from anterior

division of the mandibular
SUPPLY nerve

• Pterygoid branch of 2nd

BLOOD part of the maxillary artery
• Ascending palatine artery
SUPPLY
 ACTIONS:
LATERAL • Acting together, these muscles protrude the mandible and
PTERYGOID depress the chin. (With suprahyoid muscles)
• Acting alone & alternately, they produce side –to –side
movements of mandible.
 Palpation of
Muscle
Placing the forefinger, or the
little finger, over the buccal
area of the maxillary third
molar region and exerting
pressure in a posterior,
superior, and medial
direction behind the
maxillary tuberosity.

Ref: Burkit’s oral medicine diagnosis & treatment.

10th edition. 2003
 Prosthodontic Consideration
• Opening of mouth by pulling forward the condylar process of
mandible and articular disc ‘while head of the mandible rotates on the
articular disc
• During closure of mouth, the backward gliding of the articular disc &
condyle is controlled by slow elevation of lateral pterygoid, while the
masseter & temporalis restore the jaw to the occlusal position
• It holds the condyles in rest position
• Left lateral pterygoid & left medial pterygoid turn the chin to
right side as a part of grinding movements.
• Medial & lateral pterygoids of two sides act together & protrude
mandible, so that the lower incisors projects infront of the upper.
-Upper head is involved mainly in chewing
-Lower head is in protrusion.

Ref: Charles M. Heartwell Jr., Arthur O.Rahn’s Syllabus of complete dentures. 4 th edition. 1992
•Commonly involved muscle in MPDS .
•Unilateral failure of lateral pterygoid muscle to contract results in
deviation of the mandible toward the affected side on opening.

•Bilateral failure results in limited opening, loss of protrusion and loss

of full lateral deviation.

•In patients with nonworking side interferences, the lateral pterygoid

muscle on the opposite of the interference is sometimes painful .

Ref: Raymond J.Fonseca’s Oral and Maxillofacial Surgery, 2nd Edition, 2008.
 Assessment of Muscles
of Mastication
∙ Evaluation of the muscles of mastication forms part of
the assessment of the trigeminal nerve (CN III).
∙ Masseter can be easily tested by having the patient clench
the jaw and evaluating the volume and firmness of the
muscles.
• The other muscle of mastication supplied by the trigeminal
nerve, the pterygoids are examined by having the patient
move the jaw from the side against resistance, and protrude
the jaw.
• Contraction of each muscle causes deviation of the jaw to the
opposite side so that the weakness of the pterygoid muscles
would cause deviation of the open jaw to the ipsilateral side
Accessory Muscles of
Mastication ⮚ Buccinator
⮚ Suprahyoid Muscles
• Digastric
• Mylohyoid
• Geniohyoid
⮚ Infrahyoid Muscles
• Sternohyoid
• Sternothyroid
• Thyrohyoid
• Omohyoid
 Buccinator
(The Muscle of the Cheek)
ORIGIN
• Upper fibers – maxilla opposite molars
• Middle fibers – pterygomandibular raphae
• Lower fibers – mandible opposite molar teeth
INSERTION
• Upper fibers – straight to upper lip
• Middle fibers – decussate before passing to the lip
• Lower fibers – straight to lower lip
NERVE SUPPLY
• Lower buccal branch of facial nerve
ACTIONS
• Flattens cheek against gums and teeth
• prevents accumulation of food in the vestibule
 CLINICAL IMPORTANCE OF BUCCINATOR
MUSCLE
ON DENTURE BORDER
• For buccal flange area in mandibular impressions:
•The area is molded by massaging the cheek in an anterior- posterior direction using moderate
manual pressure against the compound.
• This moves the fibers of the buccinators muscle and the tissues of the cheek in the direction
of functional action of the buccinators muscle.
•In maxillary impressions:
• The cheek is manually molded in anterior-posterior direction using slight finger pressure
against the compound or the patient is instructed to control the amount of movement by
sucking action.

Ref: John J. Sharry’s Complete denture prosthodontics. 3rd edition, 1974.

 Digastric
This muscle has 2 bellies - Anterior & Posterior

ORIGIN & INSERTION

• Anterior belly originates from Digastric fossa at inner side of lower border of
mandible while Posterior belly originates from Mastoid notch of temporal
bone
• Both heads descend to hyoid bone & join at intermediate tendon which
is connected to hyoid bone by fibrous tissue called Digastric pulley
NERVE SUPPLY
• Anterior Belly - Nerve to Mylohyoid (branch of inferior alveolar nerve which
is a branch of mandibular nerve)
• Posterior Belly – Facial nerve
BLOOD SUPPLY
• By lingual artery & vein

ACTION
• Depresses the mandible and mostly acts in maximal depression
 Mylohyoid
This muscle forms the floor of the mouth. Flat, triangular
muscle lying deep to the anterior belly of digastric.

ORIGIN
• Mylohyoid line on medial aspect of mandible

INSERTION
• Fibers pass down & some are inserted into median raphae
& rest into the hyoid bone

NERVE SUPPLY
• By Mylohyoid nerves branch of inferior alveolar nerve

ACTION
• Elevation of the floor of mouth
• Elevates hyoid bone or depresses the mandible
 CLINICAL IMPORTANCE OF MYLOHYOID
MUSCLE
ON DENTURE BORDERS:
Mylohyoid area
Instruct the patient to place the tip of his tongue into the upper and lower vestibules on the right
and left side.

 The area to be molded is reheated and the patient and is instructed to swallow two or three times
in rapid succession.

 The tongue movements raise the level of the floor of the mouth through contraction of the
mylohyoid muscle.

Ref: John J. Sharry’s Complete denture prosthodontics. 3rd edition, 1974.

 Stylohoid
• Small muscle that lies along the upper border of the
posterior belly of digastric muscle.

ORIGIN
• Lateral & inferior aspect of styloid process of temporal
bone

INSERTION
• Into the body of hyoid bone, at its junction with the greater
cornua
NERVE SUPPLY
• Branch from facial nerve

ACTION

• Pulls hyoid bone upwards and backwards

 Geniohyoid
This is a short and narrow muscle lying above the medial part of
Mylohyoid

ORIGIN
• From the genial tubercle of symphysis

INSERTION
• At anterior surface of body of hyoid bone

NERVE SUPPLY
• Supplied by the hypoglossal nerve

ACTION
• Depresses mandible
• Elevates hyoid bone
 CLINICAL IMPORTANCE OF GENIOHYOID
MUSCLE
For mandibular impressions:
On recording labial flange and labial frenum.
 The lip is massaged from side to side to mold the compound to desired functional extension.
 In order to activate the mentalis muscle the patient is asked to pout or lick his lower lip.

For maxillary impressions in labial flange and labial frenum area:

 Manually mold the compound by externally moving the lip side to side, simultaneously applying
finger pressure to control the width of the border.
 Lift the patients upper lip and vertically place the frenum into the softened compound and mold
with your fingers using a side to side external motion.

Ref: John J. Sharry’s Complete denture prosthodontics. 3rd edition, 1974.

 MANDIBULAR MOVEMENTS AND
ROLE PLAYED BY MUSCLES
• 1. ELEVATION:
• Prime Movers: (a) Masseter
(b) Medial Pterygoid
(c) Temporalis
• Antagonist: (a) Superior Lateral Pterygoid

2. DEPRESSION:
• Prime movers: (a) Inferior lateral pterygoid
(b) Digastric
• Antagonist: (a) Elevator group muscles
3. PROTRUSION:
• Prime Movers: (a) Inferior Lateral Pterygoid
(b) Masseter
(c) Medial Pterygoid
• Antagonist: (a) Digastric
(b) Posterior Temporal
4. RETRUSION:
• Prime movers: (a) Posterior & Middle Temporal
(b) Digastric
• Antagonist: (a) Inferior Lateral
5. LATERAL:
• Prime movers: (a) Working side of temporal muscle
• Antagonist: (a) Non working side of Pterygoid muscle
 MASTICATORY MYOFASCIAL PAIN
Mastication muscle pain disorders are similar to other skeletal
muscle disorders in other parts of the body. It is characterized by
a dull regional ache with the presence of trigger points when
palpated which produces referred pain, that increases during the
function.

Applied
Anatomy MASTICATORY MYALGIA
It is characterized as a dull persistent ache overlying the jaw and
temple muscles with occasional reference to other structures such
as head, neck, ear, and teeth. Symptoms can also include a
restricted opening, fatigue, and stiffness. Signs include
tenderness of the muscles with limited range of motion.
Localized myalgia presents as sore or aching muscles, usually
affecting bilaterally at the region of masseter and temporalis
muscles

Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 MASTICATORY MYOSPASM
Myospasm also known as muscle cramp is an acute condition
resulting from a sudden, involuntary and continuous tonic
contraction of the muscle. It is characterized by acute
shortening of a single muscle and may lead to trismus
(lockjaw), pain on movement, severely limited range of
motion of the mandible.
Applied These characteristics coupled with their sudden onset at rest
allow the clinician to differentiate myospasm from other
Anatomy masticatory muscle disorders.

MYOFIBROTIC CONTRACTURE
It involves a painless shortening of muscle as a result of
fibrosis in and around the remaining contractile muscle tissue.
It follows an infectious process or trauma. There are limited
mouth opening and unyielding resistance to passive jaw
muscle stretch.
Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 MYOSITIS
Myositis is an inflammatory condition of the muscles
caused by acute trauma or infection It is
characterized by swelling, redness overlying skin and
increases the temperature over the affected area. It
results in jaw dysfunction and limited range of
movement.
Applied
TEMPOROMANDIBULAR JOINT (TMJ)
Anatomy DYSFUNCTION
TMJ dysfunction can result from an imbalance of
forces within the muscles of mastication. Grinding of
teeth at night (bruxism) is a common cause of TMJ
dysfunction secondary to a resultant imbalance in the
muscle of mastication forces from excessive
grinding of the teeth.

Ref: Burkit’s oral medicine diagnosis & treatment. 10th edition. 2003
 TETANUS
•Tetanus is a disease of the nervous system characterized
by intense activity of motor neuron and resulting in severe
muscle spasm. Caused by clostridium tetani. Pain and
stiffness in the jaws and neck muscles ,with muscle rigidity
producing trismus and dysphagia. Rigidity of facial
muscles. Sometimes whole body becomes affected.
Applied
MYOFASCIAL PAIN DYSFUNCTION
Anatomy SYNDROME (MPDS)

Muscular disorders (myofascial pain disorders) are

the most common cause of TMJ pain associated with
masticatory muscles. Etiological factors include high
stress level, poor habits including gum chewing,
bruxism, hard candy chewing, poor dentition.
Applied Anatomy
BRUXISM
• Bruxism consists of an involuntary, aimless, repetitive,
stereotyped oral activity characterized by teeth clenching
or grinding.
• The disorder is heterogeneous and distinguishes wakeful
from sleep bruxism. Wakeful bruxism arises in a variety of
psychological, neurological, and orodental conditions.
• Sleep bruxism can occur during all stages of sleep, light
sleep in particular.
• Bruxism is important to recognize and monitor because of the
extremely powerful forces exerted on teeth, periodontal
structures, temporomandibular joint, and masticatory
muscles, often causing tooth wear and destruction,
temporomandibular joint and muscle pain, as well as tension-
type headache.
Conclusion
 1. B.D.Chaurasia’s, Human anatomy, Volume 3, 9th edition
Edition
2. Muscles of mastication (preview) - Origin, insertion, functions -
Human Anatomy, Kenhub
3. Szilvia E. Mezey, Magdalena Müller-Gerbl, Mireille Toranelli,
Jens Christoph Türp. The human masseter muscle revisited:
First description of its coronoid part. Annals of Anatomy -
Anatomischer Anzeiger, 2022; 240:

References 151879 DOI: 10.1016/j.aanat.2021.151879

4. Human anatomy by dental students by M.K. Anand, 3rd ed.
5. Burkits oral medicine diagnosis & treatment 10th edition
6. Oral and Maxillofacial Surgery by Fonseca, 2nd Edition
7. Textbook of complete dentures by Charles M heartwell
8. Complete denture prosthodontics by John J Sharry.
9. Boucher’s Prosthodontic Treatment For Edentulous Patients,
7th Edition