Читать книгу Practical Procedures in Dental Occlusion - Ziad Al-Ani - Страница 15

The aim of this chapter is to provide a clear understanding of the complex neural framework involved in mastication, swallowing and speech. The key objective is the information the brain requires to understand the position of the jaw in space and it acquires this information from the teeth, temporomandibular joint (TMJ), muscles and soft tissues.

An understanding of the neural framework involved in dental occlusion is essential in determining the protocols within clinical dentistry. The neural framework comprises the central nervous system (CNS) (spinal cord and brain) and the peripheral nervous system (connects the rest of the body to the spinal cord and brain). This is a feedback and feedforward system made up of sensory fibres (registering pain, pressure and temperature) and motor fibres (providing a function such as muscle contraction).

Anatomically, another structure which is important in our understanding of the masticatory system is the brainstem, which is the posterior part of the brain continuous with the spinal cord which is composed of three regions:

 medulla oblongata

 pons

 mesencephalic area.

Why do I need to know this, I hear you ask? Well, within this area are the central pattern generators (CPGs) generally defined as a network of neurons (nerve cells) capable of enabling the production of central commands, specifically controlling stereotyped rhythmic motor behaviours such as mastication, deglutition, respiration and locomotion, among others. There is increasing evidence suggesting that some of these CPGs are interconnected for co‐ordinated control.

In this chapter we will only be dealing with mastication and deglutition. For further reading, the article by Steuer and Guertin (2019) goes into greater detail. Kandel (2012) stated that the brainstem is an important element of motor and sensory function and plays a key role in the control of mastication and deglutition.