Dominic Stone
The masseter muscle is a thick, quadrilateral muscle, with a larger, superficial portion and a smaller, deep portion. Humans have two masseter muscles, one on each side of the face, which form part of a group of four pairs of muscles used for chewing. The masseter muscle helps elevate and move the lower jaw forward. The muscle can be tested by placing your hands on each cheek and asking the patient to clench their jaw, at which point a contraction of the masseter muscle should be felt. The thickness of the masseter muscle can be determined by ultrasonography, Computerized Tomography (CT), and Magnetic Resonance Imaging (MRI).
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What You'll Learn
- Masseter muscle thickness can be measured using ultrasound scanning, Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI)
- Masseter muscle tension can be determined by ultrasonography
- Masseter muscle hypertrophy can be treated with conservative/non-surgical therapies, behaviour therapy and injection therapy
- The trigeminal nerve controls the masseter muscle and carries sensory information about touch and pain from the face
- Masseter muscle tenderness can be assessed by palpating across the muscle with your fingers to identify any taut bands
Masseter muscle thickness can be measured using ultrasound scanning, Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI)
The masseter muscle is a thick, quadrilateral muscle, consisting of superficial and deep portions. The masseter muscle is one of the dominant muscles that provide the force necessary for efficient chewing. The thickness of the masseter muscle can be measured using ultrasound scanning, Computerized Tomography (CT), and Magnetic Resonance Imaging (MRI).
Ultrasound scanning is a suitable method for imaging the superficial structures of the head and neck region. It is a non-invasive imaging technique that allows for the measurement of the cross-section and thickness of jaw muscles, providing an indication of the maximal force a muscle can exert. Ultrasound scanning is also suitable for larger-scale studies due to its advantages over CT and MRI. It is a reproducible and economical method that does not use ionizing radiation, and the equipment is easily handled and transported.
Computerized Tomography (CT) is another non-invasive imaging technique that can be used to measure the cross-section and thickness of jaw muscles. However, compared to ultrasound scanning, it may be less suitable for larger-scale studies and may have other limitations.
Magnetic Resonance Imaging (MRI) is a third method for measuring masseter muscle thickness. MRI scans can be compared with ultrasound measurements to analyze the thickness of the masseter muscle in both contracted and relaxed states. MRI is also a non-invasive imaging technique that can provide detailed images of the muscle.
These imaging techniques have been used in various studies to examine the masseter muscle in different patient groups, such as those with and without dentition or those with temporomandibular disorders. The thickness of the masseter muscle has been found to vary between different groups, and it may be related to factors such as facial morphology, bite force, and dental arch features.
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Masseter muscle tension can be determined by ultrasonography
Ultrasonography is particularly suitable for imaging the superficial structures of the head and neck region. It is an appropriate method for larger-scale studies as it is more economical and safer than other imaging techniques such as Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) as it does not use ionizing radiation.
Ultrasonography has been used in various studies to evaluate the masseter muscle. For example, a study of 30 healthy adults examined the correlation between basic participant information (such as sex, age, height, body weight, etc.) and masseter muscle ultrasonographic data. Another study evaluated the distribution and trends of masseter muscle tension in patients with temporomandibular joint (TMJ) pain, examining gender-specific differences and the impact of various TMJ disorders.
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Masseter muscle hypertrophy can be treated with conservative/non-surgical therapies, behaviour therapy and injection therapy
Masseter muscle hypertrophy is not a life-threatening condition, though it can cause some psychological distress. It is important to discuss any concerns with a dentist, who may be able to offer conservative therapy or refer you to an orofacial pain specialist or oral surgeon.
Conservative/Non-Surgical Therapies
Masseter muscle hypertrophy can be treated with conservative or non-surgical therapies, such as splint therapy. This involves using an oral appliance to help reduce the force of biting, clenching, and grinding.
Behaviour Therapy
Behaviour therapy can also be used to address the behavioural habits that may be contributing to the overworking of the masseter muscles. This includes learning techniques for relaxation, stress management, thermal therapy (applying heat or ice to sore muscles), improving sleep hygiene, and receiving dietary counselling.
Injection Therapy
Botulinum toxin type A (Botox, Xeomin, Dysport) injection therapy is a non-invasive treatment that has gained popularity, especially among Asian individuals with a square-shaped lower face. This procedure involves injecting freeze-dried botulinum toxin protein, reconstituted with sterile saline, directly into the muscle to reduce contractions. However, some patients have reported adverse events, such as paradoxical bulging.
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The trigeminal nerve controls the masseter muscle and carries sensory information about touch and pain from the face
The masseter muscle is one of the dominant muscles that provide the force necessary for efficient chewing. It is a thick, quadrilateral muscle, consisting of superficial and deep portions. The thickness of the masseter muscle can be determined by ultrasonography, where the thickness of the muscle is tested unilaterally.
The trigeminal nerve, also known as cranial nerve 5 or CN V, is a large, three-part nerve in the head that sends signals from the brain to parts of the face and vice versa. There are two trigeminal nerves, one on each side of the head. The three major branches of the trigeminal nerve are the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). The ophthalmic nerve carries sensory information from the scalp, forehead, upper eyelid, conjunctiva, and cornea. The maxillary nerve carries sensory information from the lower eyelid, cheek, nares, upper lip, upper teeth and gums, nasal mucosa, palate and roof of the pharynx, maxillary, ethmoid, and sphenoid sinuses, and parts of the meninges.
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Masseter muscle tenderness can be assessed by palpating across the muscle with your fingers to identify any taut bands
Masseter muscle tenderness can be assessed by palpating the muscle with your fingers to identify any taut bands. This involves sliding the overlying skin back and forth across the muscle. Taut bands will be evident if they are present, and once you find one, you move up and down the band applying firm pressure while asking the patient to report the most tender point. This point should then be compressed for 5 seconds with 2kg of pressure to see if the pain radiates or refers. Taut bands often feel like an overly tight "guitar string" within the muscle.
There are several types of palpation that can be used to identify taut bands: flat palpation, pincer palpation, and snapping palpation. Flat palpation involves using the padded aspect of the fingers or thumb and proceeding at a right angle across the muscle fibres while pressing them against the underlying tissue or bone. When trigger points exist, taut bands, exquisite, focal tenderness (trigger points), and a twitch response will be detected. Pincer palpation involves rolling the muscle or muscles between the tips of the digits to detect taut bands of fibres, detect exquisite focal tenderness (trigger points), and elicit local twitch responses. Snapping palpation involves locating a taut band of muscle and placing a fingertip at a right angle. Begin moving your fingers back and forth to roll the underlying fibres under the finger, like plucking a guitar string. This method aims to elicit a local twitch response and is most effective near or on the trigger point with the muscle at a neutral length or slightly lengthened.
The masseter muscle can be further divided into the deep masseter and the superficial masseter. Deep masseter palpation involves pointing out the insertion and origin on a dry skull. This site is anterior and inferior to the lateral condyle pole, posterior to the posterior edge of the superficial masseter, and beneath the zygomatic arch. Superficial masseter palpation also involves pointing out the insertion and origin on a dry skull. The anterior temporalis muscle is best palpated at the hairline and opposite the eyebrow. The posterior temporalis muscle should be palpated for tenderness using a none, mild, moderate, or severe scale.
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Frequently asked questions
The masseter muscle is a thick, quadrilateral muscle that consists of superficial and deep portions. Humans have two masseter muscles, one on each side of the face, and they are used for chewing and eating food.
The masseter muscle can be tested by examining the trigeminal nerve. This involves placing your hands on each of the patient's cheeks and asking them to clench their jaw. If a contraction is felt, this is the masseter muscle.
Masseter muscle tenderness can be tested by palpating the masseter muscle and asking the patient to rate the pressure as none, mild, moderate, or severe.
The masseter muscle can be imaged using ultrasound scanning, Computerized Tomography (CT), and Magnetic Resonance Imaging (MRI). Ultrasound imaging is particularly suitable for imaging the masseter muscle due to its lack of ionizing radiation and cost-effectiveness.
Masseter muscle hypertrophy refers to the enlargement of the masseter muscle. This condition can be caused by overworking the muscle due to emotional stress, chronic clenching or grinding, and repetitive habits such as gum chewing.
