Medial pterygoid muscle activity during the closing and compressive phases of human mastication

The lack of specific data correlating activity in the human medial pterygoid muscle with displacement of the jaw during mastication, and the hint of possible differences in function between certain mammalian species, prompted a study of unilateral mastication in six adult subjects. Muscle activity in the medial pterygoid, masseter, and anterior temporal muscles was recorded simultaneously with three-dimensional movement of an incisor point on the mandible. Signals from muscles and displacement transducer were sampled by a disc-based computer system programmed to analyze data averaged over 30 chewing cycles on each side and in some instances over 30 open-close and clench cycles. Patterns of medial pterygoid activity were consistent for the group as a whole, demonstrating activation of both muscles early in the closing cycle with strong ipsilateral muscle activity before and throughout the intercuspal phase of mastication. By contrast contralateral activity ceased during the crushing phase of the cycle, reappearing in some subjects just before the end of intercuspation. Medial pterygoid activity mirrored masseter and anterior temporal activity only during certain phases of the closing cycle, suggesting that these muscles should be considered as being selectively coactivated with, rather than synergists of, the major elevators of the jaw. The muscles were active during horizontal components of movement of the incisor teeth in chewing, but were inactive during the open-close and clench task despite vigorous contraction of the masseter muscles. Overall, the observations complement previous reports of medial pterygoid muscle activity in humans. They also confirm, for these muscles at least, a general similarity between man and the little brown bat, a relationship hitherto suspected but unsubstantiated.     

Physiological cross-section of the human jaw muscles

The cross-sectional areas of the masseter, temporalis, medial pterygoid and lateral pterygoid muscles were determined by means of computer tomography in 16 male subjects with healthy dentitions. The physiological cross-section (PCS) of these muscles was predicted from the previously determined relationship between PCS and scan cross-sections. In our subjects, mean total PCS of the jaw muscles was twice as high as in cadavers with few natural teeth. The average distribution of total PCS over the four muscles was the same in the two groups. There was considerable individual variation. Strong correlations in cross-sectional area were only found between the masseter and medial pterygoid muscles. Variation in PCS of these two muscles determines 80% of the variation in combined cross-sectional area.     

Masticatory motor patterns in ungulates: a quantitative assessment of jaw-muscle coordination in goats, alpacas and horses

We investigated patterns of jaw-muscle coordination during rhythmic mastication in three species of ungulates displaying the marked transverse jaw movements typical of many large mammalian herbivores. In order to quantify consistent motor patterns during chewing, electromyograms were recorded from the superficial masseter, deep masseter, posterior temporalis and medial pterygoid muscles of goats, alpacas and horses. Timing differences between muscle pairs were evaluated in the context of an evolutionary model of jaw-muscle function. In this model, the closing and food reduction phases of mastication are primarily controlled by two distinct muscle groups, triplet I (balancing-side superficial masseter and medial pterygoid and working-side posterior temporalis) and triplet II (working-side superficial masseter and medial pterygoid and balancing-side posterior temporalis), and the asynchronous activity of the working- and balancing-side deep masseters. The three species differ in the extent to which the jaw muscles are coordinated as triplet I and triplet II. Alpacas, and to a lesser extent, goats, exhibit the triplet pattern whereas horses do not. In contrast, all three species show marked asynchrony of the working-side and balancing-side deep masseters, with jaw closing initiated by the working-side muscle and the balancing-side muscle firing much later during closing. However, goats differ from alpacas and horses in the timing of the balancing-side deep masseter relative to the triplet II muscles. This study highlights interspecific differences in the coordination of jaw muscles to influence transverse jaw movements and the production of bite force in herbivorous ungulates.     

Changes in human jaw muscles with age and dental state

The effects of ageing and dental state on the cross-sectional area and density of two jaw muscles, the masseter and medial pterygoid, were investigated using computed tomography. The study involved 84 male and 70 female subjects between the ages of 20 and 90 years. The cross-sectional area of both muscles showed a significant reduction with age; values for female subjects being found in the lower range of the distribution. When consideration was given to the presence or absence of a natural dentition, the cross-sectional area of both muscles in edentulous subjects showed a greater decease throughout the age range studied. There was a significant decrease in the density of the muscles with increasing age. Previously, this has been interpreted to indicate a progressive increase in fat and fibrous tissue. Subject gender and the absence of teeth appeared to have little effect on this parameter. Changes in the cross-sectional area and density of these muscles would appear to be consistent with a general age related change of muscle tissue in the body as a whole and may specifically indicate a reduction in the masticatory forces which can be or are being utilised by ageing patients, many of whom have no remaining natural dentition.     

Mammals with a long diastema typically also have dominant masseter and pterygoid muscles

A few orders of mammals contain many individuals with dominant masseter and pterygoid muscles that pull up and forward as they close the jaw. A dominant temporalis muscle that pulls the jaw up and to the rear is the more common condition in mammals. A long toothless region (diastema) is present in almost all mammals with a large masseter/pterygoid complex. The presence of a diastema, when few teeth have been lost and their size has not changed significantly over evolutionary time, implies that the jaws have lengthened, as in horses and selenodont artiodactyls. (A long jaw with a shorter diastema will also form if very long incisors develop as in rodents.) The sum of the forces of all the jaw muscles (represented by an arrow) typically divides the jaw into a posterior, toothless region and an anterior region where the teeth are located. In most mammals, the sum of all the bite forces at the teeth is maximized when the lengths of the projections of these two regions, onto a line perpendicular to the arrow, are in the ratio of 3 : 7. If the tooth-bearing region of the jaws becomes longer over evolutionary time this ratio will obviously be disturbed. A change in the location of some basic bony features of the jaw mechanism could maintain this ratio, but this requires major disruption of the skull and jaws. Alternatively, simply changing the masses of the muscles that close the jaw (smaller temporalis, larger masseter and/or pterygoid, or some combination), so that the lower jaw is pulled up and forward, rather than backward, also maintains the ratio. According to this view, if the jaw lengthens over evolutionary time, the relative sizes of the jaw muscles will change so that the masseter/pterygoid complex will become dominant.  © 2008 The Linnean Society of London, Zoological Journal of the Linnean Society , 2008, 153 , 625–629.     

Control of jaw movements in two species of macropodines (Macropus eugenii and Macropus rufus).

The masticatory motor patterns of three tammar wallabies and two red kangaroos were determined by analyzing the pattern of electromyographic (EMG) activity of the jaw adductors and correlating it with lower jaw movements, as recorded by digital video and videoradiography. Transverse jaw movements were limited by the width of the upper incisal arcade. Molars engaged in food breakdown during two distinct occlusal phases characterized by abrupt changes in the direction of working-side hemimandible movement. Separate orthal (Phase I) and transverse (Phase II) trajectories were observed. The working-side lower jaw initially was drawn laterally by the balancing-side medial pterygoid and then orthally by overlapping activity in the balancing- and working-side temporalis and the balancing-side superficial masseter and medial pterygoid. Transverse movement occurred principally via the working-side medial pterygoid and superficial masseter. This pattern contrasted to that of placental herbivores, which are known to break down food when they move the working-side lower jaw transversely along a relatively longer linear path without changing direction during the power stroke. The placental trajectory results from overlapping activity in the working- and balancing-side adductor muscles, suggesting that macropods and placental herbivores have modified the primitive masticatory motor pattern in different ways.     

Control of jaw movements in two species of macropodines (Macropus eugenii and Macropus rufus)

The masticatory motor patterns of three tammar wallabies and two red kangaroos were determined by analyzing the pattern of electromyographic (EMG) activity of the jaw adductors and correlating it with lower jaw movements, as recorded by digital video and videoradiography. Transverse jaw movements were limited by the width of the upper incisal arcade. Molars engaged in food breakdown during two distinct occlusal phases characterized by abrupt changes in the direction of working-side hemimandible movement. Separate orthal (Phase I) and transverse (Phase II) trajectories were observed. The working-side lower jaw initially was drawn laterally by the balancing-side medial pterygoid and then orthally by overlapping activity in the balancing- and working-side temporalis and the balancing-side superficial masseter and medial pterygoid. Transverse movement occurred principally via the working-side medial pterygoid and superficial masseter. This pattern contrasted to that of placental herbivores, which are known to break down food when they move the working-side lower jaw transversely along a relatively longer linear path without changing direction during the power stroke. The placental trajectory results from overlapping activity in the working- and balancing-side adductor muscles, suggesting that macropods and placental herbivores have modified the primitive masticatory motor pattern in different ways.     

Loading patterns and jaw movements during mastication in Macaca fascicularis: a bone-strain, electromyographic, and cineradiographic analysis

Rosette strain gage, electromyography (EMG), and cineradiographic techniques were used to analyze loading patterns and jaw movements during mastication in Macaca fascicularis. The cineradiographic data indicate that macaques generally swallow frequently throughout a chewing sequence, and these swallows are intercalated into a chewing cycle towards the end of a power stroke. The bone strain and jaw movement data indicate that during vigorous mastication the transition between fast close and the power stroke is correlated with a sharp increase in masticatory force, and they also show that in most instances the jaws of macaques are maximally loaded prior to maximum intercuspation, i.e. during phase I (buccal phase) occlusal movements. Moreover, these data indicate that loads during phase II (lingual phase) occlusal movements are ordinarily relatively small. The bone strain data also suggest that the duration of unloading of the jaw during the power stroke of mastication is largely a function of the relaxation time of the jaw adductors. This interpretation is based on the finding that the duration from 100% peak strain to 50% peak strain during unloading closely approximates the half-relaxation time of whole adductor jaw muscles of macaques. The EMG data of the masseter and medial pterygoid muscles have important implications for understanding both the biomechanics of the power stroke and the external forces responsible for the "wishboning" effect that takes place along the mandibular symphysis and corpus during the power stroke of mastication. Although both medial pterygoid muscles reach maximum EMG activity during the power stroke, the activity of the working-side medial pterygoid peaks after the balancing-side medial pterygoid. Associated with the simultaneous increase of force of the working-side medial pterygoid and the decrease of force of the balancing-side medial pterygoid is the persistently high level of EMG activity of the balancing-side deep masseter (posterior portion). This pattern is of considerable significance because the direction of force of both the working-side medial pterygoid and the balancing-side deep masseter are well aligned to aid in driving the working-side lower molars across the upper molars in the medial direction during unilateral mastication.(ABSTRACT TRUNCATED AT 400 WORDS)     

Radiographic changes in alveolar bone height on overdenture abutments: a longitudinal study

Objective: Stabilisation of partial dentures is an important part of prosthodontic treatment, particularly in patients with an excessive reduction in alveolar bone supporting their abutment teeth. In these cases, overdenture prostheses are one possible treatment choice. Background: The aim of this study was to evaluate the effects of overdentures on the condition of alveolar bone of the remaining teeth, and to evaluate the overdenture concept in the prosthetic treatment of partially edentulous patients. Materials and methods: The investigation was conducted on 22 patients during observation periods of 6 and 10 years. After preparation, all abutment teeth were provided with either amalgam restorations or gold copings. An overdenture in the lower jaw was fabricated for every patient. A special film holder was used to repeat the X‐ray procedure in every patient in the same manner. The radiographs were evaluated using the grid scale. The alveolar bone level of all remaining teeth was evaluated on dental films by measuring the distance between the root apex and coronal border of the alveolar bone. Results: A statistically significant difference (p < 0.01) was calculated 6 years after delivery stage between distal alveolar bone levels of experimental abutments under overdentures and the remaining teeth of the control group. Alveolar bone of abutment teeth was considerably preserved, particularly in seven patients observed 10 years after provision of their dentures. Conclusion: Within the limitation of this study, the validity of the overdenture treatment in partially edentulous patients is concluded. Good oral hygiene was crucial for the success of treatment with overdentures.     

Relationships between the size and spatial morphology of human masseter and medial pterygoid muscles, the craniofacial skeleton, and jaw biomechanics

The relationship between human craniofacial morphology and the biomechanical efficiency of bite force generation in widely varying muscular and skeletal types is unknown. To address this problem, we selected 22 subjects with different facial morphologies and used magnetic resonance imaging, cephalometric radiography, and data from dental casts to reconstruct their craniofacial tissues in three dimensions. Conventional cephalometric analyses were carried out, and the cross-sectional sizes of the masseter and medial pterygoid muscles were measured from reconstituted sections. The potential abilities of the muscles to generate bite forces at the molar teeth and mandibular condyles were calculated according to static equilibrium theory using muscle, first molar, and condylar moment arms. On average, the masseter muscle was about 66% larger in cross section than the medial pterygoid and was inclined more anteriorly relative to the functional occlusal plane. There was a significant positive correlation (P less than 0.01) between the cross-sectional areas of the masseter and medial pterygoid muscles (r = 0.75) and between the bizygomatic arch width and masseter cross-sectional area (r = 0.56) and medial pterygoid cross-sectional area (r = 0.69). The masseter muscle was always a more efficient producer of vertically oriented bite force than the medial pterygoid. Putative bite force from the medial pterygoid muscle alone correlated positively with mandibular length and inversely with upper face height. When muscle and tooth moment arms were considered together, a system efficient at producing force on the first molar was statistically associated with a face having a large intergonial width, small intercondylar width, narrow dental arch, forward maxilla, and forward mandible. There was no significant correlation between muscle cross-sectional areas and their respective putative bite forces. This suggests that there is no simple relationship between the tension-generating capacity of the muscles and their mechanical efficiency as described by their spatial arrangement. The study shows that in a modern human population so many combinations of biomechanically relevant variables are possible that subjects cannot easily be placed into ideal or nonideal categories for producing molar force. Our findings also confirm the impression that similar bite-force efficiencies can be found in subjects with disparate facial features.     

Trends in the Actions of Mammalian Masticatory Muscles

The actions of the masticatory muscles of a variety of mammalsin which feeding behavior and the configuration of the masticatoryapparatus differ have been reported. The most common approachused in these studies involves (1) obtaining a good anatomicalperception of the musculature, (2) deriving a theoretical modelof the actions of these muscles during jaw movement, and (3)testing this model by recording muscle activity and jaw movementssimultaneously. A catalogue of the activity patterns in eleven species of mammalsduring food reduction reveals certain trends in the actionsof the masticatory muscles. Horizontal jaw movements are generatedprimarily by differential activities of the deep temporalis,superficial masseter, and medial pterygoid. Vertical movementsand the maintenance of tooth to food contact apparently areproduced by action of the superficial temporalis, deep masseter,and zygomaticomandibularis. Thus, horizontal movements are seeminglygenerated by muscles having fibers arranged in marked anteroposteriordirection, whereas vertical movements are generated by muscleshaving more or less vertically arranged fibers. The asymmetry of jaw movement and the muscular activity generatingit suggest that mastication involves an interactionbetween anunbalanced and flexible functional unit (muscles) and a balancedand stable structural unit (skull and teeth). Thus, any unbalancingof the structural unit results in a further unbalancing of themasticatory process.     

Tooth loss, the wearing of dentures and associated factors in Sri Lankan older individuals

Objective: To determine tooth loss, wearing of dentures and associated factors in older individuals from Sri Lanka. Design: A cross‐sectional survey where the data were collected by means of an oral examination and an interviewer administered questionnaire. Setting: Negambo within the Gampaha district of Sri Lanka. Subjects: A total of 630 subjects who were aged 60 years and above. Results: Only 11 subjects had all 32 teeth and 17% were edentulous. Age, gender and level of income were significantly associated with the number of missing teeth. Of those with missing teeth, 22% wore dentures. Only 16% of the non‐denture wearers perceived a need for dentures. Among the non‐denture wearers who perceived a need for dentures, a majority had cited ‘cost’ as the main barrier for obtaining dentures. Logistic regression analysis revealed that age, gender, levels of income and education and missing teeth were significant predictors of wearing of dentures. Conclusions: Knowledge of factors that influence tooth loss and wearing of dentures may have implications for oral health care planners in the provision and delivery of oral health services to the older individuals.     

The relationships among jaw‐muscle fiber architecture,jaw morphology,and feeding behavior in extant apes and modern humans

The jaw‐closing muscles are responsible for generating many of the forces and movements associated with feeding. Muscle physiologic cross‐sectional area (PCSA) and fiber length are two architectural parameters that heavily influence muscle function. While there have been numerous comparative studies of hominoid and hominin craniodental and mandibular morphology, little is known about hominoid jaw‐muscle fiber architecture. We present novel data on masseter and temporalis internal muscle architecture for small‐ and large‐bodied hominoids. Hominoid scaling patterns are evaluated and compared with representative New‐ (Cebus) and Old‐World (Macaca) monkeys. Variation in hominoid jaw‐muscle fiber architecture is related to both absolute size and allometry. PCSAs scale close to isometry relative to jaw length in anthropoids, but likely with positive allometry in hominoids. Thus, large‐bodied apes may be capable of generating both absolutely and relatively greater muscle forces compared with smaller‐bodied apes and monkeys. Compared with extant apes, modern humans exhibit a reduction in masseter PCSA relative to condyle‐M₁ length but retain relatively long fibers, suggesting humans may have sacrificed relative masseter muscle force during chewing without appreciably altering muscle excursion/contraction velocity. Lastly, craniometric estimates of PCSAs underestimate hominoid masseter and temporalis PCSAs by more than 50% in gorillas, and overestimate masseter PCSA by as much as 30% in humans. These findings underscore the difficulty of accurately estimating jaw‐muscle fiber architecture from craniometric measures and suggest models of fossil hominin and hominoid bite forces will be improved by incorporating architectural data in estimating jaw‐muscle forces. Am J Phys Anthropol 151:120–134, 2013. © 2013 Wiley Periodicals, Inc.     

Measurement of the size and orientation of human masseter and medial pterygoid muscles

To gain a better understanding of biting and chewing performance, the size and orientation of the masseter and medial pterygoid muscles in living humans were studied. Twenty-seven young males having complete dentition, class I dental occlusion and normal muscle and jaw function were examined using magnetic resonance images of the head between the zygomatic arch and hyoid bone. The sections were parallel to the palatal plane, and the thickness was 3 mm without a gap. A computer software program (Medical Dental Image, MDI) was developed to identify and calculate the area of each cross section of the muscle, and the volume of the muscle was then estimated. The axis of the muscle was determined by connecting the centroids of the sections in the lower and upper 1/3 of the whole muscle. The effective muscle cross section area was then calculated by resectioning the muscle perpendicularly to the muscle axis. It was found that the mean masseter muscle volume was around 31 cm3, and that the mean medial pterygoid muscle volume was 11 cm3. Their mean effective cross section areas were around 6.2 cm2 and 3.5 cm2, respectively. The axis of the masseter muscle was more perpendicular to the palatal plane and parallel to the sagittal plane than was the medial pterygoid muscle. The results suggest that the use of magnetic resonance images (MRI) is an effective noninvasive measurement technique for determining the size and orientation of masseter and medial pterygoid muscles. This technique can be employed in future studies on human bite force evaluation and masticatory function.     

Muscle strength and mineral densities in the mandible

Bone mineral density (BMD) in the femoral neck and lumbar spine was measured for 355 postmenopausal 48- to 56-year-old women and the BMD in five different regions in the mandible for 77. All 355 women were also classified according to the size of the masseter muscle. Both skeletal measures and the BMD of the buccal cortex distally from the foramen mentale were compared with the size of the masseter muscle. This study indicates that functional stress, caused by the masseter muscle, is involved in maintaining bone mineral density in edentulous regions of the mandible. Those individuals who are physically active or are bruxists may lose less mineral, after extractions of teeth, from those regions of the jaw bones where the muscles are attached.     

The orientation of the force of the jaw muscles and the length of the mandible in mammals

Ungulates generally have large masseter and pterygoid muscles and a necessarily large angular process provides attachment surface on the mandible. The temporalis muscle tends to be small. It has been suggested that this is an adaptation for enhanced control of the lower jaw and reduction of forces at the jaw joint. I suggest an additional reason: because of the geometry of the jaw, the length of that segment of the lower jaw that spans the distance from the jaw joint to the most posterior tooth is significantly reduced when the masseler and pterygoid are the dominant muscles; this region is necessarily much longer when the temporalis is large.     

Tooth loss, denture wearing and associated factors among an elderly institutionalised Brazilian population

Objective: This cross‐sectional study assessed the prevalence and extent of tooth loss as well as denture wear and associated factors in institutionalised elderly in Brazil. Background: There is scarcity of research in Brazil concerning geriatric oral health issues. Material and methods: A sample of 335 individuals over 60 years of age, representative of the institutionalised elderly from Belo Horizonte, Brazil, were selected through a stratified sampling strategy. Data were collected from structured questionnaires, reviews of medical records and intra‐oral examinations. Results: Edentulousness was observed in 74.9% of the elderly and was related to age, years of study, income, length of institutionalisation, systemic diseases and mini‐mental score. Among the dentate subjects, 17.9% possessed 20 or more teeth. Approximately half the edentulous elderly (42.6%) and most of the partially dentate subjects (66.7%) did not wear dentures. The multivariate analysis showed that subjects that wear dentures were more likely to be female, possess higher incomes, be more functionally independent and married. Furthermore, the odds of wearing dentures among the elderly who had lost 13–32 teeth were 9.11 times higher than those who had lost up to 12 teeth. Conclusion: Tooth loss is highly prevalent in this institutionalised Brazilian population, and the prevalence of denture wear is low. The extent of tooth loss, income, functional status and marital status are important predictors for denture wear. The development of an oral health programme for these individuals should assist in their rehabilitation needs and promote in‐home care or safe transport for the elderly to a health care location.     

Oral status and its association with obesity in Southern Brazilian older people

Background and objective: The loss of a functional dentition imposes eating difficulties and food avoidance, which may be detrimental in terms of nutritional status and health. The objective of this study was to investigate whether tooth loss and edentulism that were not rehabilitated with dental prostheses were associated with obesity among elderly in Southern Brazil. Materials and methods: A random sample of 872 independently living elderly was evaluated by means of a cross‐sectional study. Socio‐demographic, medical history and behaviour data were assessed using a standardised questionnaire. Two trained dentists assessed the number of teeth and use of prostheses in accordance with the WHO criteria. Height and weight were assessed and used to generate body mass index (BMI = weight (kilos)/height (cm)²) data. Participants were categorised into non‐obese (BMI ≤ 30) or obese (BMI > 30). Multivariate logistic regression was used to model the relationship between number of teeth and use of dental prostheses with obesity adjusting for confounders. Results: Multivariate logistic regression revealed that edentulous persons wearing only upper dentures (OR = 2.34, 95% CI 1.18–4.27) and dentate participants with one to eight teeth wearing 0‐to‐1 prosthesis (OR = 2.96, 95% CI 1.68–5.19) were more likely to be obese. Conclusion: The results show that a poorer oral status, represented by having fewer teeth that were not replaced by dental prostheses, was associated with obesity in Southern Brazil older people, suggesting a close relationship between poor oral status and systemic conditions that may have important clinical implications.     

The masseteric jaw-jerk reflex in older dentate subjects and edentulous denture wearers

The aim of the present study was to investigate any variations in the jaw-jerk reflex in edentulous subjects wearing complete dentures, compared to an age and sex-matched dentate group. The reflex was elicited by chin taps in 22 older dentate subjects with mean age 61.3 years and in 22 denture wearers with mean age 63.1 years. Surface electromyographic recordings were obtained from the masseter muscle of the preferred chewing side during mandibular rest and at moderate clenching (40% of the individual maximum clenching masseteric EMG activity). A jaw-jerk reflex was recorded in all subjects at least once, and its occurrence during clenching was reduced compared to rest. The occurrence of the reflex was however increased in the denture wearers in both experimental conditions, while minor differences were observed in the values for latency, duration and amplitude between the two dental status groups. These results suggest that under the present experimental conditions the periodontal ligament receptors might inhibit reflex activity. Multiple sensory interactions are expected in denture wearing. However a particular source of sensory feedback is provided by the stimulation of mucosal receptors from the acrylic denture base. Since the occurrence of the jaw-jerk at clench in the denture wearers was also reduced compared to the rest experiments, a potential inhibitory effect of the mucosal receptors can be speculated. According to the findings in the present study the loss of teeth and the rehabilitation with complete dentures do not severely disrupt the reflex activity investigated.     

Responses of jawbone to pressure

Objective: To provide a literature review of bone resorption of edentulous jaws focusing on responses to pressure. Background: After the extraction of all teeth in a jaw there is a continuous reduction of the residual ridge. The individual variation of bone resorption is great, and the aetiology is complex and not yet well understood. Materials and methods: A search of the literature published up to May 2003 on bone resorption and pressure was performed using PubMed/Medline. Results: Animal studies have demonstrated that excessive and constant pressure induces bone resorption. Recent experimental research has indicated that bone resorption is a pressure‐regulated phenomenon with a lower threshold for continuous than for intermittent pressure. Clinical studies have suggested that residual ridge resorption is due more to the effects of denture wearing than to disuse atrophy. However, the results of leaving out dentures at night are not conclusive. Nor does the literature offer any strong evidence for the so‐called combination syndrome, which has been described as a result of unfavourable loading. Clinical studies using multivariate analyses indicate that female gender and systemic factors may be of greater importance than oral and denture factors. Implant‐supported prostheses have a bone preserving effect rather than the continuing resorption under complete dentures. Conclusions: The best way to reduce bone resorption is to avoid total extraction, preserve a few teeth and fabricate overdentures. In edentulous jaws, placement of implant‐supported prostheses will lead to less bone loss and may even promote bone growth. To increase our knowledge of residual ridge resorption extended experimental, clinical and statistical methods will be needed, preferably including collaboration between dental and medical researchers.