Masseter muscle is a rather powerful facial muscle and one of the four muscles that is predominantly involved in mastication or rather the chewing of solid foods. It also happens to be one among the three muscles that account for the strength of the bite. Masseter muscle plays an important role in facial aesthetics as it is located laterally to the mandibular ramus in its inferior portion. This is where the facial contour tapers.In patients with a chronic tendency to clench the jaw or grind teeth or if they are habitual gum-chewers then this masseter muscle can get enlarged. This not so common condition that can cause both aesthetic as well as functional problems is called Masseter Hypertrophy. This soft enlargement of the jaw muscles at the angle of the lower jaw can appear aesthetically displeasing affecting the symmetry and proportion of the face. The physical signs are normally a wide mandibular angle, a rectangular face shape or a very prominent looking masseter muscle.
Masseter Hypertrophy is dependent on a number of factors like tensions and clenching caused by emotional disorders like stress or nervousness, chronic bruxism, defective teeth, temporo-mandibular joint disorder, congenital and functional hypertrophies, masseteric hyperfunction, and parafunction. This can also be due to secondary conditions like muscle tumours, salivary gland disorders or intrinsic masseter myopathy and hence a proper clinical diagnosis is mandatory. Patients with a long – term incidence of Masseter Hypertrophy may complain of well-localized pain or other symptoms like tooth wear, fracture of the teeth and restorations, toothache, masticatory muscle pain, temporomandibular joint pain, and tension-type headache. This condition has found to be common in some ethnic groups.
As for the treatment of Masseter Hypertrophy, muscle relaxants are usually given in the case of jaw pain. Some procedures like bite adjustments or usage of splints in teeth, Dental restorations and occlusal adjustments to correct premature contacts are other methods. In the current times most, people go for non-invasive or non-surgical and less-risky treatment options for altering the face shape or to reduce the volume or width of the masseter muscle. The jaw can be reduced surgically or Botulinum toxin Type A injections can also be given to treat this condition. This powerful neurotoxin is directly injected into the muscle area that needs treatment. The toxin causes an interference with the neurotransmitter mechanism producing selective loss of muscle function and also a reduction in the muscle mass. There are cosmetology techniques that administer lower doses of the toxin and addressing both the masseter muscle and the parotid gland for more effective results.
The Masseter hypertrophy condition may occur unilaterally or bilaterally and is often characterized by an increase in the volume of the muscle mass. Other disorders like parotid gland illnesses, odontogenic problems, and rare tumours of muscular tissue may also have similar presentation. A proper diagnosis can be made from clinical examination, panoramic x-ray, CT or MRI scans or muscle palpitation. A misdiagnosis can often lead to unnecessary biopsies, explorative surgeries or even radiotherapies when this condition is suspected as parotid tumour.
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