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The Buccinator MechanismThe Buccinator Mechanism
Dr. KAPIL SAROHA BDS, MDS
ORTHODONTICS AND DENTOFACIAL ORTHOPAEDICS
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CONTENTSCONTENTS INTRODUCTION ORO-FACIAL MUSCLES BUCCINATOR BUCCINATOR MECHANISM ROLE IN MAINTAINING ARCH FORM AND
TEETH POSITION ROLE IN MALOCCLUSION USE IN TREATMENT OF MALOCCLUSION CONCLUSION
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IntroductionIntroductionThe muscles of oral region are
involved in functions of swallowing , respiration and speech . They not only affects the physical and aesthetic appearance but also influences the dental and skeletal components of an individual .
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it is believed that abnormal posture and function of oro-facial muscle may be causative or at least contributory to formation of dental malocclusion
Hence muscle of oro-facial region are of great importance to one of the main aims of orthodontics that is to achieve structural balance and harmony.
Which is achieved only when there is harmony between jaw , teeth and muscles .
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Facial musclesFacial muscles
They can be classified as – Muscles of mastication– Muscles of facial expression
Circumorbital muscles Nasal muscles Oro-facial muscles
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They constitute to form the modiolus Modiolus literally means “ hub of wheel”It forms the mesial boundary of occlusal
tableThese muscles are important for facial
expression and also in maintaining posture of various facial structures
Any abnormality in these muscles function can lead to skeletal or occlusal problems
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BuccinatorBuccinatorIt is a quadrilateral muscle between maxilla and
mandible it forms the mobile and adaptive substance of
cheek origin
Arises from outer surface of alveolar process of maxilla and mandible opposite third molar teeth and posteriorly attached to pterygomandibular raphe
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InsertionAnterior buccinator fibers converge
towards the modiolus near the buccal angle
The central fibers decussates so that it continues into the orbicularis oris muscle
While the highest and lowest fibers enter into the corresponding lips
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ActionsActionsIt draws the corner of the mouth laterally
pulling the lips against the teeth and flattens the cheek
It aids in functions like swallowing , blowing etc
keeps cheek in close contact with teeth so prevents pocketing of food between teeth and the cheek
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Buccinator mechanismBuccinator mechanismStarting with the decussating fibers of the
orbicularis oris the buccinator runs laterally and posteriorly around the corner of the mouth it inserts into the pterygomandibular raphe just behind the dentition
Here it mingles with the fibers of superior constrictor which attaches to pharyngeal tubercle of occipital bone
Thus completely encircling the face
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Strong inter-dependence occur between bone and muscle although bone is one of the hardest tissues in body it is one of the most responsive to change whenever there is an alteration to in environment balance. The most important in this environment balance is the musculature
The teeth and supporting structures are constantly under influence of contiguous musculature buccinator and lips and lips on other side
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Role of buccinator mechanism in Role of buccinator mechanism in maintaining arch form and teeth maintaining arch form and teeth
positionposition
The integrity of dental arches and the relationship of the teeth to each other within each arch and with opposing members are result of morphogenetic pattern as modified by stabilizing and active function forces of muscle the tongue on one side and lips and cheek on other side
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Importance of pressure from lips and cheek can be derived from a case of cancrum oris . Here there was an ulceration followed by gangrenous distribution of buccal mucosa . As the cheek was destroyed the teeth began to move outwards under the unopposed pressure from the tongue
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Similarly in case of un-repaired cleft lip one often sees proclination of incisors although in buccal segments where cheek are normal teeth are in normal relationship
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Another concept was given by Wifred fish of neutral zone - acc to him the teeth occupy a dead space in mouth in a state of equilibrium . The inwards pressure by cheek and lips is balanced by the outward pressure of tongue
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The dental arch form is determined early in fetal life and form of basal arch does not change. It is believed as long as total pressure acting on teeth is balanced the position of teeth is stabilized
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Use of buccinator mechanism Use of buccinator mechanism in correcting malocclusionin correcting malocclusion
Alfred Paul Rogers was first to recommend use of muscles to correct malocclusion
Myofunctional appliance depend on oro- facial muscle for their function
Its essence was to use muscle activity as a primary source for resolution of malocclusion
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