ORAL MUCOSA

S 2 07-3208284 wcwang@kmu.edu.tw

:
1. Nanci A: Ten Cates Oral Histology, Development, structure, and function 6th ed. p.329-75 2. Orban BJ :Orbans oral histology and embryology,9th ed. p.261-334 3. Avery JK: Essentials of Oral Histology and Embryology: A clinical approach. 2nd ed. p.16483
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Oral mucosa

MUCOUS MEMBRANE
Definition: -Moist lining of the intestinal tract, nasal passages and other body cavities that communicate with the exterior

Oral mucosa: Oral mucous membrane

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vermillion border labial mucosa labial frenum vestibule

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buccal mucosa buccal frenum occlusal line orifice of Stensons duct

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dorsal surface ventral surfrace lingual frenum tongue border

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interdental papilla attached gingiva mucogingiva

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hard palate soft paalte uvula

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Oral mucosa

FUNCTIONS OF ORAL MUCOSA Protection Sensation Secretion Thermal regulation

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Oral mucosa

STRUCTURE OF ORAL MUCOSA

Epithelium ..epidermis Lamina propria ..dermis Submucosa ..subcutaneous

* Epithelial ridges, rete pegs

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Oral mucoperiosteum

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Oral mucosa

EPITHELIUM
stratified squamous cell Keratinized basal prickle granular keratinized Nonkeratinized basal prickle intermediate superficial

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Keratinization Basal cell prickle granular keratinized layer

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Oral mucosa

Basal cell layer

Cuboid or columnar shape Containing bundles of tonofibrils and cell organs Synthesize DNA, protein Most cell divisions

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Oral mucosa

Prickle cell layer (spinous cell layer)

Irregularly polyhedral shape Conspicuous tonofibril bundles Membrane-coating granules in upper part Intercellular bridge- Desmosome Most active in protein synthesis

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Oral mucosa

Granular cell layer

Flatter & wider Keratohyaline granules Tonofibrils Membrane-coating granules Synthesis protein

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Oral mucosa

Keratin layer
Flattened & dehydrated Lost all organelles Cell filled with packed fibrillar material

orthokeratin

parakeratin

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Oral mucosa

Intermediate layer of nonkeratinized epi.

Flattened cells Tonofilaments & glycogen

Superficial layer of nonkeratinized epi.

Flattened cells Tonofilaments & glycogen Fewer organells Nuclei persist
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Oral mucosa

Nonkeratinocytes in the oral epi.

Melanocyte melanin, premelanosome, melanosome Langerhans cell regulatory, antigen trap Merkels cell tactile sensory Lymphocyte inflammatory response **Clear cells: Melanocyte, Langerhans cell, Merkels cell

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Oral mucosa

Intercellular Junctions
Desmosome (Hemidesmosome) Tight junction Gap junction Intercelluar bridge

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FUNCTIONAL CLASSIFICATION OF ORAL MUCOSA

Keratinized areas Masticatory mucosa-hard palate & gingiva Vermilion border Nonkeratinized areas Lining or reflecting mucosa lip, cheek, alveolar mucosa, vestibular fornix, mouth floor, soft palate, ventrum of tongue Specialized mucosa dorsum of the tongue

Oral mucosa

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Oral mucosa

Hard Palate
1.different zones of palatine mucosa gingival region, palatine raphae, fatty zone, glandular zone(mucous gland)

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2. tight fixed to the underlying

periosteum
* No submucous layer: gingiva region and palatin raphe (mucoperiosteum) 3. epithelium uinform in form, wellkeratinized

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Oral mucosa

Gingiva
1. Parakeratinized 75%, orthokeratinized 15%, nonkeratinized 10% 2. often showing stippled surface

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3. Free gingiva, free gingiva groove, attached gingiva, interdental gingiva, mucogingival junction

4. coldepressed part of interdental papilla, thin nonkeratinized epi.

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Oral mucosa

Vermilion border of lip

Transitional zone between skin of lip and lip mucosa No gland

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Oral mucosa

Nonkeratinized Areas
Lining or reflecting

mucosa

lip,cheek, alveolar mucosa, vestibular fornix, mouth floor, soft palate, ventrum of tongue Thick nonkeratinized epi. and varied amount of loose textured submucosa (containing fat & gland) movably attached to the deep structure
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Oral mucosa

Fordyces spots (granule)

Isolated sebaceous gland buccal mucosa near mouth angle and opposite the molars

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Fordyces granule

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Oral mucosa

Specialized Mucosa
Dorsal lingual mucosa Lingual Papillae
Filiform papilla: entire ant part of tongue, no taste bud Fungiform papilla: tongue tip Foliate papilla: lateral border of post. Tongue
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Circumvallate papilla: before V-shape terminal sulcus, 8-10 in number

von Ebners glands, main source of salivary lipase

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Foliate papilla

Circumvallate papilla Fungiform papilla

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Oral mucosa

Taste Buds
1. Ovoid or barrel-shaped intraepi. organ
2. Taste pore 3. Supporting cells 4. 10-12 neuroepithelial cells (receptors of taste)

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WenChen Wang

Oral mucosa

Taste Sensation
Sweet-fungiform papilla Salty-fungiform Bitter -circumvallate Sour- foliate

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Summary
ORAL MUCOSA STRUCTURE OF ORAL MUCOSA Keratinized vs. Nonkeratinized Keratinocytes in the oral epi Nonkeratinocytes in the oral epi FUNCTIONAL CLASSIFICATION Keratinized areas Nonkeratinized areas Specialized mucosa WenChen Wang

Salivary gland

SALIVARY GLAND

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:
1. Avery JK. Oral development and histology. 2nd edition, Chapter 21, p. 352-81 2. Berkovitz BK, Holland GR, Moxham BH. 2nd edition, p.215, 220 3. de Almeida PDV, et al.. Saliva Composition and Functions: A Comprehensive Review. J Contemp Dent Pract 2008 3:72-80
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Salivary gland

CLASSIFICATION OF SALIVARY GLAND 1. By location 2. By size

Major Salivary Gland

Parotid gland Submandibular gl. Sublingual gland

Minor Salivary Gland Labial and buccal, palatine, lingual
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Salivary gland

CLASSIFICATION OF SALIVARY GLAND 3. By structure: Mucous gland Serous gland Mixed gland

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Salivary gland

STRUCTURE OF SG
Acinus cells Duct system Connective tissue:
fibrous septa and capsule blood vessels nerves
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 acinic cells
mucous cell , serous cell or mixed acini

Terminal tubule: acinic cell + myoepithelial cell

Terminal secretory units: Terminal tubule+ intercalated duct cell

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Salivary gland

Mucous cell
pale Low-protein, high carbohydrate Mucin: glycoprotein, sialic acid Viscous Lubrication

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Salivary gland

Serous cell
Dark stain High -protein, low carbohydrate rER, lysosome, mitochondria, secretory granule, zymogen granules (amylase) Watery consistency Digestion
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Salivary gland

Myoepithelial cell
Surrounding the acinic cell and intercalated duct Long process like smooth m. in ultrastructure Contractile function, helping to extraction
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Salivary gland

Demilunes:
mixed acini mucous cells (inner) + serous cells

Cell Junctions:
Tight junction
Intermediate junction Desmosome
characteristics of ectodemal origin
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Salivary gland

SALIVA produced by terminal secretory units

striated duct interlobular duct excretory duct main duct

(ex. Stensens duct)

ORAL CAVITY
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MAJOR SALIVARY GLAND

Salivary gland

Parotid gland
Size Location largest retromandibular fossa, infra-auricular Main duct Stensens duct Opening buccal mucosa respect to 2nd molar Acini serous acini Saliva Vol. 25-30%

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Salivary gland

Submandibular gland
Size Location intermediate submandibular triangle, below mylohyoid m. Main duct Wartons duct Opening Caruncula sublingualis, mouth floor Acini mixed acini, serous predominate Saliva Vol. 60%
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Salivary gland

Sublingual gland
Size smallest ( a main gland and several small glands) Location mouth floor, above mylohyoid m. Main duct Bartholins duct Opening sublingual fold Acini mixed acini, mucous predominate Saliva Vol. 5%
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Salivary gland

MINOR SALIVARY GLANDS

about 7% of total saliva

Labial and buccal (mixed) glossopalatine (pure mucous) palatine (pure mucous) lingual (mixed)

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Salivary gland

SALIVA : COMPOSITION AND FUNCTION

750ml produced daily, pH 6.7-7.4 99% or more: WATER 1% or less: inorganic ions, secretory glycoproteins, serum constituents, and others
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Salivary gland

SALIVA : COMPOSITION AND FUNCTION

Lumbrication ...mucins, proline-rich proteins Buffering .bicarbonate Remineralization ...calcium , phosphate Digestionamylase, lipase, proteases Antimicrobial property ...proline-rich proteins, lysozyme, histatins, lactoperoxidase, IgA Protection. water, mucins Wound healing... growth factors

Homeostasis of Oral Cavity

Salivary gland

COMMON CAUSES of salivary dysfunction

Aging Infection, inflammation, obstruction Side effects of drugs Autoimmune disease (ex. Sjgrens syndrome) Diabetes Mellitus, alcoholism Neoplasm Head and neck Radiotherapy
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Salivary gland

DENTAL COMPLICATIONS related to salivary dysfunction

Xerostomia Rampant caries Periodontitis Secondary infection

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Summary
SALIVARY GLAND
CLASSIFICATION
By location, size & structure

STRUCTURE
Connective tissue Ducts Terminal secrectory units

SALIVA : COMPOSITION AND FUNCTION CLINICAL CONSIDERATION

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