Oral Function

Question 1

what is the origin insertion and function of masseter

Answer 1

origin - zygomatic arch
insertion - lateral border of the ramus of mandible
function - elevation of mandible

Question 2

what is the origin insertion and function of temporalis

Answer 2

origin - temporal bone
insertion - coronoid process of mandible
function - elevation and retraction of mandible

Question 3

what is the origin insertion and function of medial pterygoid

Answer 3

origin - medial surface of ptyergoid plate
insertion - angle of mandible
function - elevation and protrusion of mandible

Question 4

what is the origin insertion and function of lateral pterygoid

Answer 4

origin - lateral surface of pterygoid plate
insertion - condyle of mandible
function - depression, protrusion and lateral movement

Question 5

how can the integrity of masseter be tested and what patients might find this sensitive

Answer 5

one finger intra-orally, one extra-orally, can feel bulk of muscle between. may be sensitive in those with clenching problems

Question 6

how can the integrity of temporalis be tested and what patients might find this sensitive

Answer 6

ask patient to bite together, palpate at the tempal near eye. sensitive in patients with bruxism

Question 7

how can the integrity of lateral pterygoid be tested

Answer 7

cannot be palpated as is too deep. but is sensitive to resistance movements. ask patient to depress mandible whilst pushing against, or ask to move jaw side wards while pushing against it. clicking of jaw suggests muscle spasm due to fatigue. splint will relax muscle

Question 8

what causes trismus

Answer 8

damage to medial pterygoid muscle during ID block, muscle paralysed, unable to fully depress mandible due to lack of rotation

Question 9

what are the movements of the TMJ

Answer 9

rotation and translation (sliding)

Question 10

what shows the movement of TMJ

Answer 10

posselt’s envelope, shows the protrusion, opening and occlusion

Question 11

where has maximum biting force

Answer 11

posterior teeth - closest to fulcrum

Question 12

what are some possible complications with administrating an ID block

Answer 12

LA into muscle - medial pterygoid - trismus
LA into soft tissue, filtrate through to parotid gland - Bell’s palsy
LA into nerve - temporary trauma, blocked for longer than required, may get parasthesia - tingly sensation when it is being restored

Question 13

what can be done for bells palsy patients

Answer 13

nothing can be done, no treatment, will resolve on it’s own with time. administer an eye patch as blinking reflex is not possible, need to protect cornea

Question 14

what nerves are involved in the gag reflex

Answer 14

glossopharyngeal - afferent
uses interneurones then efferent
trigeminal, facial, glossopharyngeal, accessory, vagus, hypoglossal

Question 15

how can patients with a gag reflex be managed

Answer 15

if require denture - avoid a post dam, anything too posterior will not be tolerated
when taking impressions - tilt head forward
put impression tray in at the back first, then move forwards
make impression material thick and with warm water to induce faster set

Question 16

why is it important to retain roots even if not crowns for denture

Answer 16

PDL fibres with receptors
mechanoreceptors - provide sensory information about types of food, alters the mastication and force of muscles to tailor to food, jaw jerk reflex
interdental discrimination - can feel as small as a hair between teeth
proprioception - know the movement of jaw and mastication, without thinking about it

discrimination between foods, functional loading, control of mandibular movement, psychological benefit

Question 17

what feature allows to recognise the mint in your mouth has a hole in the middle

Answer 17

two point discrimination - between tongue and hard palate

Question 18

what can cause dysphagia and what would you do with a patient complaining of this

Answer 18

stroke, brain injury, tumour, ms
can rule out stroke by testing motor and sensory function - would be unilateral and forehead would be spared
refer to hospital

Question 19

what are the stages of swalowing

Answer 19

ingestion, transport, mechanical processing

Question 20

what is involved at the ingestion stage of swallowing

Answer 20

getting food into mouth, using anterior teeth to bite into smaller sizes

Question 21

what is involved at the transport stage of swallowing

Answer 21

using posterior teeth to break into smaller sizes for swallowing, using tongue to move to back of mouth and side to side

Question 22

what is involved in the mechanical processing stage of swallowing

Answer 22

when food is ready to be swallowed, put on tongue, this then moves back and up toward the hard palate, pushes against to break food bolus up more, as the contact zone moves posteriorly, the bolus in contact with the pharyngeal surface of the tongue, able to flow straight into oro-pharynx - squeeze back mechanism

Question 23

what muscles are involved in swallowing

Answer 23

muscles of mastication, buccinator, orbicularis oris, tongue muscles, suprahyoid

Question 24

what phases are involved in the chewing cycle

Answer 24

opening phase - jaw depressor muscles
closing phase - jaw elevator muscles
occlusal phase - ICP, muscles relaxed

Question 25

what affects the chewing cycle

Answer 25

the hardness of food - soft food, wide cycle, hard food more narrow cycle
malocclusion - out of cycle
worn occlusion - wider cycle

Question 26

when should the chewing cycle be considered

Answer 26

when designing a denture for a patient, if we know how they are used to eating, can alter the denture so this is maintained. sharp cusps - narrow cycle, more worn down - wider cycle

Question 27

why might a shortened dental arch be recommended

Answer 27

if a patient has 20 teeth, healthy non carious, have maximum function, aesthetic, speech, may not have reason for restoration - unless absence causes problem. better oral hygiene than introducing prosthesis

Question 28

what restoration has lowest biting force and which has highest

Answer 28

lowest - complete denture, mucosa borne only, cannot resist high forces, causes bone resorption
highest - implant, bone supported, still not PDL but can have denture off of this

Question 29

what fixed appliances can be used for restorations

Answer 29

cantilever or fixed fixed bridge. involves crown prep on abutment teeth

Question 30

what is adhesive bonded bridge

Answer 30

when the pontic is bonded to a surface of abutment teeth, instead of crown being used. cantilever or 2 abutment teeth. using this is dependant on health and condition of abutment teeth

Question 31

what muscles are involved in changing the shape and position of the tongue

Answer 31

extrinsic - genioglossus, hyoglossus, palatoglossus, styloglossus

Question 32

what are the intrinsic muscles of the tongue

Answer 32

vertical, transverse and longitudinal

Question 33

what muscles are involved in chewing

Answer 33

suprahyoid muscles - stylohyoid, mylohyoid, digastric, geniohyoid, facial muscles - buccinator, orbicularis oris, muscles of mastication and tongue muscles