Soft tissues 1

Soft TissuesMorphology & Behaviors

Dr. Maamar Al-Samet BDS, MDS Department of Orthodontics, Jazan University

Growth studying…Why?!!! A kid with

GHD

The best worldwide player

Dr. Maamar Al-Samet, Faculty of dentistry, Jazan University

Growth studying…Why?!!!


Soft Tissues Morphology & Behavior

Introduction Muscle balance Facial proportion The lips

Competent lips Incompetent lips

The tongue Oral seal swallowing Mouth breathing


Introduction Increased demand of

orthodontic Tx

Esthetic problems

Importance of facial soft tissues balance


Esthetic?!!!Even ancient Egyptians did.



Introduction Facial proportion Muscle balance The lips




Facial proportions

Facial height :

• Upper face• Middle face• Lower face

3 equal thirds


Lower face proportions

Upper lip length = 1/3

Lower lip length = 2/3

Facial proportions


Facial proportions

Facial breadth:

“Rule of transverse fifths”

Between helix of outer ears.

Each fifth = width of 1 eye.



Introduction Facial proportion Muscle balance The lips




Muscle balanceEffects of cheek and

lips are counteracted by the tongue.

Muscle balance


Alteration of muscle balance:

Equilibrium theory

Tooth position changed in response to the exerted pressures (light and sustained)

Teeth

Lips

Cheeck

Tongue

Cheeck

Muscle balance


Equilibrium theory

Lost left check by tropical infection

Buccal movement of teeth Dr. Maamar Al-Samet, Faculty of dentistry, Jazan University

Large tongue + thyroid deficiency

Mandibular prognathism

Equilibrium theory



Introduction Muscle balance The lips

Competent lips Incompetent lips Lip seal

The tongue Oral seal swallowing

Mouth breathing Other oral tissues

Fraenum Periodontal and effect of other tissues


Lips

In lower third face Importance:

1. Lip seal (mouth breathing, swallow).2. Phonation, facial esthetic.Dr. Maamar Al-Samet, Faculty of dentistry, Jazan University

Lips

COMPETENT LIPS INCOMPETENT LIPS


Competent lips

Features: Lips in contact at rest and function with

minimal contraction of circum-oral muscles lip separation at rest should be not more

than 4 mm.Dr. Maamar Al-Samet, Faculty of dentistry, Jazan University

2016

Incompetent lips

Features:

Wide gap between upper and lower lip in relaxed state (without minimal muscle activity)


Lip strain Excessive muscular activity to close the

lips is indicated by puckering of the chin due to mentalis contraction.

“ Potentially competent lip”

Incompetent lips


Incompetent lipsCauses:1- Morphological

Short upper lip. “primary

incompetent lips”.


Incompetent lips

Causes:2-Antero-posterior

discrepancy “ class II division 1”


Incompetent lips

Causes:3- Vertical

discrepency:Increased lower face height


Incompetent lips

Causes:4- Maxillary dental

protrusion:lower lip falls between upper and lower incisors


Lip seal (Normal oral seal)

Importance of lip seal: (swallow, breathing…)


Lip seal (Normal oral seal)

Normal oral seal: Lip contact No muscular activity Jaws in rest position


To Be Continued ……..


The tongue muscular

structure that forms part of the floor of the oral cavity.

Plays a major role in Oral seal Swallowing


http://en.wikipedia.org/wiki/Oral_cavity

Oral seal

In case of incompetency of lips

Called “Adoptive oral seal”

Important in swallowing


Oral seal

NORMAL LIP SEAL ADOPTIVE ORAL SEAL


Adoptive oral seal

1- LIP-TRAP LIKE

Contact “tongue – lower lip”


Adoptive oral seal

Seen in open bite

2- Lip-palate contact


Adoptive oral seal

Seen in class III

3- Tongue-upper lip


Swallowing

Primary atypical swallowing: Inborn atypical

pattern of neuromuscular activity

Infantile more forward position of the tongue

Tongue in contact with lips during swallowing


Swallowing Normal adult

swallowing: Mature swallow seen by

18 of age Teeth together Mandible stabilized by

muscle of mastication Tip of tongue behind

incisors Minimum contraction of

circumoral musclesDr. Maamar Al-Samet, Faculty of dentistry, Jazan University

STAGES OF MATURE SWALLOWING

1- Oral Phase. 2- Pharyngeal Phase . 3- Esophageal Phase.

Swallowing


1- ORAL PHASE

Soft palate moves upward and tongue drops backward and downward

Larynx and hyoid move upward

Bolus is pushed by tongue and liquid flows

Stabilization of mandible is done by muscle of mastication.

Stages of mature swallowing


2- PHARYNGEAL PHASE The bolus passes

through the fauces Nasopharynx is closed Tongue and hyoid

move upward.



3- ESOPHAGEAL PHASE Food passes through

the esophagus to the stomach.



Swallowing

Primary atypical swallowing: Increased over jet Decreased overbite Posterior cross bite


Mature swallow vs. Atypical swallow


Mouth breathing

NASAL BREATHING MOUTH BREATHING


Mouth breathing

Causes of mouth breathing:

• Adenoidism• Rhinitis • Pharyngitis …

etc Effect of mouth

breathing: Adenoid facies Abnormalities in all

planes of space Dr. Maamar Al-Samet, Faculty of dentistry, Jazan University

Mouth breathing


ET VOILA`

The End

C`est Fini

Thank you

Soft tissues 1

Health & Medicine

Transcript of Soft tissues 1