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Role of Facial Muscles in Complete Denture Prosthesis: a Review

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Role of Facial Muscles in Complete Denture Prosthesis: a Review e-ISSN: 2581-4443 MAVEN | www.idahowrah.org REVIEW ARTICLE Role of Facial Muscles in Complete Denture Prosthesis: A Review Dr. Anindita Majumder 1, Prof. (Dr.) Sugata Mukherjee 2, Prof. (Dr.) Tapan Kumar Giri 3, Dr Ashish Barui 1, Dr Dibyatanu Majumder 1 1Post graduate student, 2Professor and Head of department, 3Professor and Principal, De- partment of Prosthodontics Crown and Bridge, Dr R Ahmed Dental College and Hospital. Kolkata. Corresponding author: Dr. Anindita Majumder, Post graduate student, Department of Prosthodontics Crown and Bridge, Dr R Ahmed Dental College and Hospital. Kolkata. Phone no- 8697687883, Email - [email protected]. Abstract We prosthodontist treat patients with complete denture prosthesis, that replaces missing teeth and maxillofacial tissues. A successful prosthesis requires balance between difeerent related factors and must fullfill the following criteria- of being in harmony with surrounding oral environment and orofacial musculature and preservation of remaining structures, re- stores masticatory efficiency; ability to perform during functions like deglutition, speech, respiration; and be aesthetically pleasing. Among these criteria maintaining harmony be- tween prosthesis and muscles and preservation of the same is of utmost importance and a challange to the dentist. Muscle action influences the fabrication of denture at every step beginning from impression making to jaw relations to teeth setting and finally successful retention, stability and comfortable wearing of denture. Similarly a properly constructed denture helps to restore the health of stomatognathic system of which muscle are a part. It helps muscle to function in its physiological limit and maintain tonicity. So in this review the role of facial muscles in complete denture prosthesis is presented here. (2018, Vol. 02; Issue 02: Page 56 - 62) Key words: Muscles of facial expression, Buccinator, Modiolus, Orbicularis oris. Introduction the craniofacial tissues to perform me- “Muscle is of primary interest because it chanical work. performs mechanical work.” This is a According to GPT -8 Muscle is defined as statetment by Rahn and Heartwell (1). an organ that by contraction produces When muscles are stimulated, tension de- movements of an organism: a tissue com- velops in the fibres and contraction oc- posed of contractile cells or fibres that af- curs along the long axis of the fibres. fects the movements of an organism or This contraction of fibres is responsible for part of the body. the development of forces which acts on There are several histological level of or- ganization seen in muscle – the basic 57 contractile unit in a muscle are myofi- Epicranial, Circumorbital and Palpebral, brils. Myofibrils are packed together to Nasal, Buccol-labial groups. form a single muscle fibre, which are sur- Epicranial, circumorbital and palpebral, rounded by a layer of connective tissue nasal groups of muscles are responsible called endomysium. Muscle fibres are for facial expression of different emotions grouped together to form bundle or fasci- of a person. culi. A layer of connective tissue sur- Buccinator, Orbicularis oris, Incisivus su- rounds each fasciculi as well as the perioris and inferioris and Bucco- labial spaces between the fasciculis is called the groups are of main concern to the Prostho- perimysium. Finally several fasciculi or dontist as these muscles have immense bundles surrounded by a layer connective influence on the fabrication and success- tissue called the epimysium, forms the ful denture performance, aesthetics and muscle. patient compliance. Most of the orofacial muscles are striated Orbicularis oris is the sphincter muscle of skeletal muscles. They comprises of both the mouth. It has no skeletal attachment type -1 (slow) fibres and type -2 (fast) fi- except through the attachment of inci- bres, of varying proportion that reflects sivus indirectly (3). the function of that particular muscle. It is a composite muscle composed of : Most of the orofacial muscles have same • Intrinsic fibres: oblique fibres ex- properties like that of other muscles in the tending from skin to mucosa of oral body which includes : Excitability, Con- cavity traction, All or none law, Muscle tone, • Extrinsic fibres: derived from other Muscle memory (2). facial muscles and arranged in The oro-facial muscles influencing com- three strata: Deepest – originates plete denture prosthesis are muscles of fa- from incisivus superioris and infe- cial expression, muscles of mastication, rioris, Intermediate – from buccina- muscles of tongue, muscles of soft palate, tor and they decussates into oppo- pharyngeal muscles, suprahyoid muscles, site lips, Superficial – from levator infra hyoid muscles. In this review a detail and depressor anguli oris , their fi- description of facial muscles are only dis- bres cross each other at angle of cussed here. mouth and passes to opposite lips. • This layer also receives fibres form Muscles of facial expression other muscles to form modiolus. These muscles generally donot insert Action- Orbicularis oris is the main mus- into the bone. They are subcutaneous in cle of lip. Intrinsic fibres helps in articu- position and produces wrinkles or fold in lation of speech. Deep layer compresses the skin when they contract. They are re- the lip against the teeth and the superfi- sponsible for expression of different emo- cial layer protrudes the lip (3). tions of an individual. Morphologically Buccinator - It is horseshoe shaped muscle they are remnants of panniculus carno- that originates from the outer surface of sus. Topographically and functionally they alveolar process of maxillae and mandible are divided into following groups ; opposite the molar teeth, and partly from Maven, 2018, Vol – 02(2) 58 the pterygomandibular raphe a fibrous Levator labii superioris arises from lower band arises which extends to maxillary tu- margin of orbit just above infra orbital fo- berosity. ramen and inserts into the upper lip. Its Insertion –Fibres travels to the mesial as- action is to elevate and evert upper lip and pect of first molar and on reaching the an- to increase naso-labial furrow (1). gle of the mouth fibres get arranged into Levator labii superioris alaeque nasi arises three layers: Upper group passes to upper from maxilla and inserted into ala of nose lip and lower group into lower lip, while in- by one slip and upper lips by another slip. termediate layer decussate at modiolus Its action is to dilate nostril. It elevates and goes to opposite lips. and everts upper lip. Action – It pulls the corner of mouth lat- Depressor labii inferioris arises from erally and backward. A major function of oblique line of mandible and inserted into this muscle is to keep cheeks taught. If skin of lower lip. It pulls lower lip down- this was not so then when the jaws close, ward and laterally (3). the cheek would collapse and be caught Depressor anguli oris arises from the pos- within teeth. During mastication it con- terior part of the oblique line of mandible tracts and places the food particles on the and gets inserted in the angle of the mouth occlusal table from the buccal vestibule , through which it extends further into the (3). skin of upper lip. It draws the angle of Incisivus superioris and inferioris arises mouth downward and laterally, as in ex- from incisive fosae and blends with orbic- pression of sadness (1). ularis oris. Its action is to make the vesti- Risorius is a variable slip of muscle, arises bule shallow hence influence flange thick- from parotid fascia as a continuation of ness and extension. posterior fibre of platysma and inserted Zygomaticus major and minor arises from into angle of mouth. It retracts the angle zygomatic bone and inserted into the an- of mouth in greening (3). gle of mouth. Its action is to draw the an- gle of mouth upward and laterally as in Role of facial muscles in expres- smiling (1). sion of emotion Mentalis origin from incisive fosae and in- Emotions of joy – Joy or happiness re- serted into the skin. Its action is protru- flected in an individual in varying degree, sion of lips. It makes lower vestibule shal- depends upon the intensity of emotion ex- low when it contracts. perienced and the emotional level of the Levator anguli oris arise from maxilla person. It may range from quite warmth of below infra-orbital foramen and inserted a smile to a roaring laughter. In either sit- into the angle of mouth where it intermin- uation the muscles of the lips and cheeks gles with other muscles and extends into play dominant role and their action is ac- skin of lower lip. Its action is to raise the companied by brightening and lightening angle of mouth. Combined action with le- of the eyes. vator labii superioris and zygomaticus mi- Smile - “Physically and psychologically a nor muscles accentuates naso-labial fur- smile enhances ones outward appearance row, in expression of sadness (3). and tend to improve self confidence and Maven, 2018, Vol – 02(2) 59 feeling of self worth”. A smile may be of even be exposed. The distance between the slight and momentary or intense and pro- nasal septum and vermillion border of lips longed, may or may not be accompanied is decreased. Nasolabial fold deepens and by sound. It may be a facial overtone dur- its cranial part becomes horizontal Man- ing speech, resulting in modification of dibular lip bowed downward with marked certain speech sound. concavity but teeth are not exposed (5). During smiling following muscle actions Emotion of distress - In distress the mouth are noted: is firmly closed with corners of mouth ex- Contraction of zygomaticus major – tending downward. This is achieved by draws the angle of the mouth and tensing of muscle inserted in the modioli modiolii upward and backward . and fixes the modioli pushing of mandib- Contraction of levator labii superi- ular lip under and against maxillary lip by oris – elevates the maxillary lips, orbicularis oris muscle action.
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