ORAL MUCOSA...2020/10/09 · ORAL MUCOSA IS A PART OF AN ORAL BIOLOGICAL SYSTEM MO, food, air mo,...
Transcript of ORAL MUCOSA...2020/10/09 · ORAL MUCOSA IS A PART OF AN ORAL BIOLOGICAL SYSTEM MO, food, air mo,...
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ORAL MUCOSAHISTOGENESIS, MORPHOLOGY AND PHYSIOLOGY OF
THE ORAL MUCOSA AND GINGIVA. FEATURES IN
CHILDHOOD.
Assoc. Prof. Dr N. Mitova
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ORAL MUCOSA
• THE MOIST LINING OF THE ORAL CAVITY IS CALLED ORAL
MUCOSA OR ORAL MUCOUS MEMBRANE;
• ORAL MUCOSA IS CONTINUOUS WITH THE SKIN OUTSIDE
THE ORAL CAVITY AND DIFFERS FROM IT IN APPEARANCE
AND STRUCTURE;
• THE FUNCTION OF THE ORAL MUCOSA IS PROTECTION,
SENSATION AND SECRETION.
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NORMAL ANATOMY OF THE ORAL MUCOSA
Oral mucosa covers the entire oral cavity;
Starts from the lips and is adjacent to the skin –Vermillion;
Lined vestibule, alveolar bone, hard and soft palate above, tongue and floor of the mouth below.
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ORAL MUCOSA IS A PART OF AN ORAL BIOLOGICAL SYSTEM
MO, food,
air
mo, food, air,
saliva
Salivary
glands
Saliva, air, food
tooth
Оral mucosa
МО
IgA-S-
Планктонниклетки
а
МОМОmo
general
immunity
local immunity
and tolerance
gingival
fluid
planktonic
cells
gingiva
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HISTOGENESIS OF THE ORAL MUCOSA
From the primary ectoderm;
From the primary mesoderm.
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THE ORAL MUCOSA IS DEVELOPED AROUND PRIMARY MOUTH
• ORAL PIT - 4 MO IN UTERI;
• ORAL POCKET - BETWEEN THE
FOREBRAIN AND THE HEART;
• OROPHARYNGEAL MEMBRANE - THE
DEEPEST PART OF THE POCKET;
• RUPTURE OF THE MEMBRANE - 5 MO;
• PRIMARY MOUTH;
• THE ECTODERM COVERS ORAL CAVITY
INTO THE PHARYNX AND DOWN IS
COVERED BY ENDODERM.
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VESTIBULAR LAMINA• IT IS SEPARATED JAWS FROM THE SOFT
TISSUE;
• ORAL ECTODERM COVERS ALL INTERNAL
ORAL STRUCTURES;
• BEGINS CELL DIFFERENTIATION;
• BASAL COLUMNAR CELLS ARE PREPARED
FOR CONSTANT RENEWAL;
• FOLDING OF A BASAL LAYER;
• STRENGTHENING THE BASAL LAMINA;
• SPECIALIZATION OF THE MUCOSA IN
THE DIFFERENT AREAS OF THE MOUTH.
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ORAL ECTODERM
• WITH THE DEVELOPMENT OF TEETH THE ORAL ECTODERM IS
SEPARATED FROM THE DENTAL;
• WITH ERUPTION OF THE TEETH IS PERFORMED REUNION OF
THESE TWO LAYERS;
• IT BECOMES A FUSION OF THE REDUCED ENAMEL
EPITHELIUM AND ORAL EPITHELIUM;
• GINGIVAL COLLAR IS FORMED OF THESE TWO LAYERS;
• IT IS FORMED:
• THE GINGIVAL SULCUS;
• THE EPITHELIAL ATACHMAN OR JUNCTIONAL EPITHELIUM.
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STRUCTURE OF ORAL MUCOSA
The oral cavity is lined with stratified epithelium, which is divided into three types:
• Lining mucosa;
• Masticatory mucosa;
• Specialized mucosa.
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LINING MUCOSA
• LINING MUCOSA –
COVER THE FLOOR OF
THE MOUTH AND THE
CHEEKS, LIPS, AND SOFT
PALATE;
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MASTICATORY MUCOSA
• IT COVERS THE HARD
PALATE AND ALVEOLAR
RIDGES;
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SPECIALIZED MUCOSA
• WHICH COVERS THE
SURFACES OF THE
TONGUE.
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All of the oral mucosa is
made up of a thick
stratified squamous
epithelium, supported by
a lamina propria;
The epithelium is thick
because the epithelial
lining of the oral cavity is
subject to a lot of wear
and tear.
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ORAL MUCOSA• IN MOBILE AREAS, SUCH AS THE SOFT
PALATE, UNDERSIDE OF THE TONGUE,
FLOOR OF THE MOUTH, AND
MUCOSAL SURFACES OF THE CHEEKS
AND LIPS, THE EPITHELIUM IS NOT
KERATINISED.
• IN OTHER AREAS, SUCH AS THE
GUMS (GINGIVAE), HARD PALATE,
AND MOST OF THE UPPER SURFACE
OF THE TONGUE, THE EPITHELIUM IS
KERATINISED.
• UNDERNEATH THE ORAL MUCOSA,
THERE IS A TOUGH COLLAGENOUS
SUBMUCOSAL LAYER, WITH
ACCESSORY SALIVARY GLANDS,
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COMMON FEATURES OF THE MUCOSA
Lamina propria – the connective tissue layer immediately below the epithelium;
It is composed of the:
• Papillary layer – connective tissue extends into pockets in the epithelium – this increases the surface of the epithelium for contact with vascular supply and nerves;
• And deeper reticular layer – contains the deeper plexus of vessels and nerves;
Beneath this zone is the submucosa.
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SCHEME OF AN ORAL MUCOSA
• PAPILLARY FOLDS;
• MULTILAYERED
EPITHELIUM;
• BASAL LAMINA;
• LAMINA PROPRIA:
• LAMINA LUCIDA;
• LAMINA DENSA;
• SUBMUCOSA
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DIFFERENT TYPES OF MUCOSA
прикрепенаattached
Специализирана -по езика
Free
Specialized
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EACH TYPE OF TISSUE HAS STRUCTURAL DIFFERENCES
• THE LINING MUCOSA IS:
• SOFT;
• PLIABLE;
• NONKERATINIZED.
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MASTICATORY MUCOSA:
• IS KERATINIZED;
• INDICATIVE OF THE
ATTRITION, THAT TAKE
PLACE DURING
MASTICATION.
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SPECIALIZED MUCOSA:
• THIS IS THE MUCOSA OF THE TONGUE SURFACE;
• IT IS COMPOSED LARGELY OF CORNIFIED EPITHELIAL PAPILLAE;
• THEY ARE FUNCTIONING IN MASTICATION.
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LAYERS OF EPITHELIUM
• STRATUM CORNEUM
• STRATUM GRANULOSUM
• STRATUM SPINOSUM
• STRATUM BASALE
(GERMINATIVUM)
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KERATANIZED EPITHELIUM
There is a pronounced papillary layer;
It lacks submucosa;
You can see the 4 epithelial layers.
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STRATUM BASALE
• THE BASALE LAMINA IS AT
THE INTERFACE OF THE
EPITHELIUM AND LAMINA
PROPRIA;
• EPITHELIAL CELLS OF THE
ORAL MUCOSA ARE IN A
CONSTANT STATE OF THE
RENEWAL;
• THE BASAL CELLS SHOW
THE MAXIMUM MITOTIC
ACTIVITY.
The cells of the stratum
basale are cuboidal or low
columnar and form a single
layer resting on the basale
lamina.
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BASAL LAYER
Their nuclei are irregularly oval and exhibit numerous mitotic figures as they undergo constant cell division;
This basal cells gradually migrate to the surface of the mucosa.
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CELLS OF THE SQUAMOUS EPITHELIUM
The basal cells gradually
migrate to the surface of the
mucosa and undergoes
changes.
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CELL RECOVERY
The cells of the oral epithelium are recovering for 1 to 2 weeks:
The cells of the attached epithelium - for 1 week;
Cells of the marginal gingiva - 2 weeks;
They contain within itself proliferative department implementing rapid division;
New cells are packed with tonofilaments which are attached to the basal lamina.
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STRATUM SPINOSUM
• THE CELLS LIKE
POLYHEDRON WITH SHORT
CYTOPLASMIC PROCESSES;
• THE STRATUM BASALE AND
STRATUM SPINOSUM ARE
REFERRED AS STRATUM
GERMINATIVUM BECAUSE
THIS CELLS GIVE RICE TO
NEW EPITHELIAL CELLS.
Stratum spinosum is
usually several cells
thick.
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STRATUM GRANULOSUM
• CELLS OF STRATUM GRANULOSUM
ARE FLAT AND ARE FOUND IN LAYERS
OF THREE TO FIVE CELLS THICK;
• THIS LAYER IS PROMINENT IN
KERATINIZED EPITHELIUM (AND
ABSENT IN NONKERATINIZED
EPITHELIUM);
• THEY HAVE KERATOHYALIN
GRANULES IN THEIR CYTOPLASM;
• KERATOHYALIN GRANULES HELP TO
FORM THE MATRIX OF THE KERATIN
FIBERS FOUND IN THE SUPERFICIAL
LAYER.
It is so named because the cells contain
many keratohyalin granules;
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STRATUM CORNEUM
• CELLS OF THE STRATUM
CORNEUM ARE FLAT,
DEVOID OF NUCLEI AND
FULL OF KERATIN FILAMENT
SURROUNDED BY A
MATRIX;
• THIS CELLS ARE
CONTINUOUSLY BEING
SLOUGHED AND ARE
REPLACED BY EPITHELIAL
CELLS THAT MIGRATE FROM
THE UNDERLYING LAYERS.
This soft keratin may be
compared with hard keratin
of the nails and hair;
Keratin is tough, nonliving
material that is resistant to
friction and impervious to
bacterial invasion.
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CELL SIZES IN THE DIFFERENT LAYERS OF THE GINGIVAL EPITHELIUM
• TO PERMIT CELL MOVEMENT AND LOSS OF INDIVIDUAL CELLS ALONG THE SURFACE, THE
SUPERFICIAL LAYERS HAVE SURFACE INTERDIGITATIONS RATHER THAN DESMOSOMES;
• THIS CELLS ARE CONTINUALLY BECOMING LOST AND REPLACED BY CELLS OF THE
UNDERLYING LAYERS.
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• TO PERMIT CELL MOVEMENT AND LOSS OF INDIVIDUAL
CELLS ALONG THE SURFACE, THE SUPERFICIAL LAYERS
HAVE SURFACE INTERDIGITATIONS RATHER THAN
DESMOSOMES;
• THIS CELLS ARE CONTINUALLY BECOMING LOST AND
REPLACED BY CELLS OF THE UNDERLYING LAYERS.
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MOVEMENT OF THE EPITHELIAL CELLS
• AS EACH CELL MOVES TO THE SURFACE OF THE EPITHELIUM, IT DOES
SO BY MEANS OF CELLS ATTACHMENTS TO NEIGHBORING CELLS
THAT HOLD UNTIL THE CELL HAS REACHED A SPECIFIC STAGE OF
DEVELOPMENT;
• WHEN THAT STAGE OCCURS, THE CELL ATTACHMENT RELEASES,
WHICH ALLOWS THAT CELL TO MOVE TO A HIGHER LEVEL WHERE IT
REATTACHES.
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BASAL LAMINA• BASAL CELLS INTERFACE WITH A
MEMBRANE SEPARATING THE
EPITHELIUM AND CONNECTIVE
TISSUE;
• THIS MEMBRANE IS CALLED THE
BASAL LAMINA;
• THE BASAL CELLS ARE ATTACHED
TO THE BASAL LAMINA BY MINUTE
DISKS TERMED HEMIDESMOSOMES;
• THESE THICKANINGS OF THE CELL
MEMBRANE ARE SUPPORTED BY
FILAMENTS FROM WITHIN THE
CELLS, ANCHORING FIBRILS THAT
ATTACH THE BASAL LAMINA AND
THE CELLS TO THE COLLAGEN
FIBERS OF THE LAMINA PROPRIA.
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Structure of the basement membrane
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THE INTRACELLULAR BINDING OF THE EPITHELIAL CELLS
Cohesion - by desmosomes;
Adhesion – by hemidesmosomes;
Focal contacts - by transmembrane proteins;
Gap-links - produce holes between cells;
Functional elements of a certain type of relationship is called connecting complex
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COHESION - BY DESMOSOMES
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ADHESION – BY HEMIDESMOSOMES
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FOCAL CONTACTS - BY TRANSMEMBRANEPROTEINS
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Gap-links - produce holes between cells
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MUCOSAL CONNECTIVE TISSUE
Connective tissue supports other tissues and organs;
It provides a blood supply, innervation and immune protection of the oral mucosa;
It is composed of:
Cells;
Intercellular substance - glikoaminoglikans;
Fibers ;
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SUBMUCOUSE
Laminapropria:
• Papillary layer;
• Reticular layer
Submucosa.
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collagen fibers
consist of fibrils (0.2 to 0.5 μm);
They are built of parallel microfiber = (50 nm);
Molecular structure of microfibers is tropokollagen;
Composed of 3 polypeptide chains, which are dominated by the amino acids glycine, proline, hydroxyproline and hydroxylysine.
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COLLAGEN FIBERS
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RETICULAR FIBERS
• THEY ARE ARGYROPHILIC
FIBERS WHICH ARE
CONSISTING OF 5%
COLLAGEN AND 15% LIPIDS;
• THE MAIN INGREDIENT IN
THEM IS RETICULIN;
• THEY ARE CONNECTING WITH
ENDOTHELIUM AND PROVIDE A
STATIC POSITION OF BLOOD
VESSELS.
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ELASTIC FIBERS
Very thin - 0.1-0.2 μm;
Forming anastomosis with each other and have a frilly edge;
They are built of elastin, which is not destroyed by proteolytic enzymes;
In the free mucosa elastic fibers are few.
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MASTICATORY MUCOSA
• IT COVERS:
• THE GINGIVA;
• THE HARD PALATE;
• IT IS ADAPTED TO CHEWING FORCES;
• IT IS KERATINIZED;
• THERE ARE SHARP RELIEF;
• IT POSSESSES STRONGLY FOLDED CONNECTIVE TISSUES
PAPILLAE;
• IT HAS A SMALL AMOUNT OF SUBMUCOSA.
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MASTICATORY MUCOSA
• THIS MUCOSA IS TICKER THAN THE NONKERATINIZED
SURFACE OF FLAT, HORNYFIED CELLS OFFERING
RESISTANCE TO ATTRITION;
• THE BASAL AND INTERMEDIATE STRATUM LAYERS
(SPINOSUM) ARE THE SAME AS THOSE OF
NONKERATINIZED EPITHELIUM.
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DEGREE OF KERATINIZATION
nonkeratinized
keratinized
Specialized with areas
with a different
keratinization
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GINGIVA AND EPITHELIAL
ATTACHMENT
• THE GINGIVA SURROUNDED THE
NECKS OF THE TEETH AND EXTENDS
APICALLY TO THE MUCOGINGIVAL
JUNCTION;
• THE GINGIVA DEVELOPS AS A
COALESCENCE OF THE ORAL AND
REDUCED ENAMEL ORGAN
EPITHELIUM WHEN THE TOOTH FIRST
EMERGES INTO ORAL CAVITY;
• THE REDUCED ENAMEL ORGAN
EPITHELIUM MAKES CONTACT WITH
THE UNDERSURFACE OF THE ORAL
EPITHELIUM, AND THE TWO FUSE;
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• THEN THE TOOTH PENETRATES
THIS COMBINED LAYER TO
ENTER THE MOUTH AND
PRODUCES THE GINGIVA AS
THE EPITHELIUM CONTINUES
TO SEPARATE FROM ENAMEL
SURFACE UNTIL OF THE TEETH
IS REACHED;
• AT THIS POINT, THE GINGIVA
COVERS ONLY THE CERVICAL
AREA OF THE ENAMEL WHERE
IT IS ATTACHED.
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FREE AND ATTACHED GINGIVA
• THE FREE GINGIVA IS
BOUND ON ITS INNER
MARGIN BY THE GINGIVAL
SULCUS, WHICH SEPARATES
IT FROM THE TOOTH;
• ON ITS OUTER MARGIN BY
THE ORAL CAVITY;
• AND APICALLY AT ITS FREE
SURFACE BY THE FREE
GINGIVAL GROOVE.
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MUCOGINGIVALJUNCTION
• THE ATTACHED GINGIVA LIES
ADJASENT TO THE FREE GINGIVA
AND IS SEPARATED FROM THE
ALVEOLAR MUCOSA BY THE
MUCOGINGIVAL JUNCTION;
• THE FREE AND ATTACHED GINGIVAE
ARE KERATINIZED, BUT THE ALVEOLAR
MUCOSA IS NOT;
• THE ATTACHED GINGIVA IS STIPPLED,
BUT THE FREE GINGIVA HAS A
SMOOTH SURFACE;
• IN SOME INSTANCES, THE FREE
GINGIVA MAY BE COVERED WITH
PARAKERATINIZED MUCOSA
(PRESENCE OF NUCLEI IN THE CELLS
OF THE SURFACE LAYER).
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JUNCTIONALEPITHELIUM
• IT PROVIDES ATTACHMENT
FOR THE GINGIVA TO THE
TOOTH IN THE CERVICAL
AREA AND FORMS THE
EPITHELIUM-LINED FLOOR
OF THE GINGIVAL
SULCUS;
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CELLS OF THE ATTACHED EPITHELIUM• THEY ARE CYTOLOGICALLY
DIFFERENT FROM THE GINGIVAL
EPITHELIUM;
• THEY HAVE FEWER DESMOSOMES;
• THIS INDICATED A HIGHER RATE
OF TURNOVER THEN OCCURS IN
THE OTHER GINGIVAL EPITHELIAL
CELLS;
• THIS CELLS ARE TURN OVER IN
APPROXIMATELY 6 DAYS.
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SULCUS EPITHELIUM
Multilayered nonkeratinizedepithelium;
Goes smoothly from marginal epithelium and cover the walls of the sulcus;
Sulcus epithelium is relatively impermeable to the passage of cells and fluid as compared to attached gingiva
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• STRATUM BASALE CELLS ALSO CONTAIN HEMIDESMOSOMES, THE MECHANISM
FOR THE ATTACHMENT OF CELLS TO SALIVARY PROTEIN LAYER, WHICH COVERS
THE CERVICAL AREA OF THE ENAMEL;
• DISTURBANCE OF THIS ATTACHMENT RESULTS IN A DEEPENING OF THE GINGIVA.
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JUNCTIONAL EPITHELIUM
Outside is in contact with the tooth, and the inside – with connective tissue of the gingiva;
Apically it reaches the bottom of the sulcus;
Formed epithelial cuff around the tooth - the fat in the bottom of the sulcus -10 - 30 cells;
Apically is thinning to a few cells.
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MARGINAL GINGIVA
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INTERDENTAL PAPILLA AND COL
• GINGIVA LOCATED
BETWEEN THE TEETH AND
EXTENDING HIGH ON THE
INTERPROXIMAL AREA OF
THE CROWNS ON THE
LABIAL AND LINGUAL
SURFACES IS KNOWN AS
THE INTERDENTAL PAPILLA;
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Positional relationship of the col in the health and disease
1. The col is accentuated in inflamation;
2. The col is found to be pointed in anterior teeth and flat or
concave posteriorly;
3. The contact point on each crown is represented by an oval
above the col.
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THE COL
• THE JUNCTIONAL EPITHELIUM OF THIS
ZONE IS KNOWN AS THE COL;
• THE COL IS CHARACTERIZED AS A
THIN, NONKERATINIZED EPITHELIUM;
• THE COL IS MORE INCLINED IN A
PEAK BETWEEN ANTERIOR TEETH AND
MORE FLATTENED OR CONCAVE
BETWEEN POSTERIOR TEETH;
• WHEN THE INTERPROXIMAL GINGIVA
BECOMES INFLAMED, THE COL IS
EXAGGERATED AND IS POSITIONED
HIGHER ON THE NECK OF THE
TOOTH.
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HARD PALATE
• THE ROOF OF THE MOUTH IS HARD
PALATE;
• IT IS COVERED WITH KERATINAZED
SRATIFIED SQUAMOUS EPITHELIUM;
• THIS EPITHELIUM IS SIMILAR TO THAT OF
THE GINGIVA IN THE MIDDLING AREA,
WHERE THERE IS NO SUBMUCOSA;
• THE MIDLINE IS KNOWN AS THE MEDIAN
RAPHE;
• ANTERIORLY AN INCISIVE PAPILLA CAN
BE SEEN;
• ON EACH SIDE OF THE MEDIAN RAPHE
ARE RIDGES OF TISSUE CALLED RUGAE.
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PALATAL MUCOSA
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KERATINIZED EPITHELIUM OF THE HARD PALATE
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STRATUM GRANULOSUM OF THE HARD PALATE
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SLOUGHED EPITHELIAL CELLS
The surface of the epithelium is a subject to constant renewal
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LINING MUCOSA
• IT IS COMPOSED OF A THIN LAYER OF EPITHELIUM AND AN
UNDERLYING LAMINA PROPRIA;
• THE EPITHELIUM IS COMPOSED OF:
• A BASAL LEYER – STRATUM BASALE;
• STRATUM SPINOSUM OR STR. INTERMEDIUM;
• STRATUM SUPERFICIALE WITH FLATTENED CELLS AND MANY
CONTAINING SMALL OVAL NUCLEI;
• FORM THE NONKERATINIZED EPITHELIUM.
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NONKERATINIZED EPITHELIUM
Surface epithelial layer is denser.
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TYPES OF LINING MUCOUSA
• SUBDIVIDED INTO MUCOUSA OF THE:
• LIPS;
• SOFT PALATE;
• CHEEKS;
• FLOOR OF THE MOUTH;
• VENTRAL SURFACE OF THE TONGUE;
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LIPS• THE INNER ORAL SURFACE OF THE
LIPS IS LINED WITH MOIST SURFACE,
STRATIFIED SQUAMOUS CELLS, AND
NONKERATINIZED EPITHELIUM;
• IT IS ASSOCIATED WITH SMALL,
ROUND SEROMUCOUS GLANDS OF
THE LAMINA PROPRIA;
• THEY ARE PART OF THE MINOR
SALIVARY GLANDS FOUND
THROUGHOUT THE ORAL CAVITY;
• BENEATH THE LAMINA PROPRIA IS
SUBMUCOSA WITH THE FIBERS OF
THE ORBICULARIS ORIS MUSCLE.
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INNER ORAL SURFACE OF THE LIPS IS LINED WITH NONKERATINIZED EPITHELIUM
• IT IS ASSOCIATED WITH SMALL,
ROUND SEROMUCOUS GLANDS
OF THE LAMINA PROPRIA;
• BENEATH THE LAMINA PROPRIA IS
SUBMUCOSA, IN WHICH FIBERS
OF THE ORBICULARIS ORIS
MUSCLE ARE LOCATED.
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VERMILION BORDER
• MUCOSA OF THE LIPS IS DISTINGUISHED BY A RED BORDER KNOWN AS THE VERMILION
BORDER;
• THIS IS THE JUNCTION BETWEEN THE ORAL MUCOSA AND THE SKIN OF THE LIPS,
BECOMING MODIFIED INTO KERATINIZED EPITHELIUM, DIFFERENT FROM SKIN OR
MUCOSA.
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THERE ARE TREE REASONS THAT THE VERMILION IS RED:
• THE EPITHELIUM IS THIN;
• THIS EPITHELIUM
CONTAINS ELEIDIN,
WHICH IS TRANSPARENT;
• THE BLOOD VESSELS ARE
NEAR THE SURFACE OF
THE PAPILLARY LAYER,
REVEALING THE RED
BLOOD CELLS` COLOR.
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FLOOR OF THE MOUTH
• NONKERATINIZED MUCOUS
MEMBRANE COVERS THE
FLOOR OF THE MOUTH AND
APPEARS LOOSELY ATTACHED
TO THE LAMINA PROPRIA;
• IN THE FLOOR OF THE
MOUTH ARE MINOR SALIVARY
GLANDS;
• AND THE RIGHT AND LEFT
ARE MAJOR MUCOUS
GLANDS – THE SUBLINGUAL
GLANDS.
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SOFT PALATE
• LINING MUCOSA OF THE SOFT PALATE IS HIGHLY
VASCULARIZED AND MORE PINK THAN THE MUCOSA OF
THE KERATINIZED EPITHELIUM OF THE HARD PALATE;
• LAMINA PROPRIA CONTAINS MANY SMALL BLOOD
VESSELS;
• BENEATH THE CONNECTIVE TISSUE OF LAMINA PROPRIA IS
THE SUBMUCOSA, WHICH CONTAINS MUSCLES AND
MUCOUS GLANDS.
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CHEEKS
• THE MUCOSA OF THE CHEEKS IS LIKE THAT OF THE LIPS OR
SOFT PALATE;
• IN THE CHEEKS, HOWEVER, THE SUBMUCOSA CONTAINS
FAT CELLS AND MIXED GLANDS (SEROMUCOUS) LOCATED
WITHIN AND BETWEEN THE MUSCLE FIBERS;
• THE PRESENCE OF THESE GLANDS AND FAT CELLS IS A
UNIQUE FEATURE OF THE CHEEKS.
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THE TONGUE
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THE TONGUE
Dorsal surface of the tongue;
Lower surface of the tongue
The 2/3 of the front of the tongue - mobile part of the tongue.
It is situated in front of the line of circumvallate papillae;
The root of the tongue – last 1/3.
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FILIFORM PAPILLAE
They are covering the entire front surface of the tongue;
They create conditions for retention of food and microorganisms;
Involved in the fragmentation of the food in pressure on the palate.
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FILIFORM PAPILLAE
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FILLIFORM PAPILLA
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FOLIATE PAPILLAE, MUSCLES, BLOOD VESSELS
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Foliate papillae are located on the lateral border towards the back of the
tongue. They appear flat and leaf-like. These type of papillae are hard to
see since they flatten on the tongue's surface and are located so far back.
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FUNGIFORM PAPILLAE
Red, raised structures;
Covered with nonkeratinized epithelium;
Are scattered between filiform papillae;
They have taste buds at the surface.
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FUNGIFORM PAPILLAE
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FUNGIFORM PAPILLAE
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CIRCUMVALLATE PAPILLAE
V-shaped
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CIRCUMVALLATE PAPILLA WITH THE TASTE BUDS
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CIRCUMVALLATE PAPILLAE
They are in front of the terminal sulcus
They are 8 to 12 major papilla
Each papilla is surrounded by a deep groove
Inside of the sulcus is poured ductusof small serous salivary glands;
Lateral walls of the papillae have taste buds.
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BLOOD SUPPLY AND INNERVATION OF THE TASTE BUDS
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TASTE BUDS INCIRCUMVALLATE PAPILLA
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PORES OF TASTE BUDS
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Fungiform papillae are located on the lateral border and tip of
the tongue. They are broader, taller and fatter then filiform and
are pink to red in color. Fungiform are the taste buds for sweet,
salty, and sour. Fungiform are the broad, red papillae in this
picture.
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FOLIATE PAPILLAE
Represent 4 to 11 parallel ridge;
Separated by deep grooves;
They are situated at along side edge of the back of the tongue;
They have a taste buds.
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FOLIATE PAPILLAE
At the back of the tongue
Behind circumvallatepapillae.
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LINGUAL TONSILS
Behind circumvallatpapillae;
They are part of Valder`soropharyngeal ring;
They are oval and convex, coupled with lingual crypts;
They are covered with nonkeratinized epithelium.
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LINGUAL TONSILS
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PLICA FIMBRIATA
A linear projection of the ventral surface of the tongue;
Sometimes is brown.
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Circumvallate papillae are located towards the back of the tongue. They
are the largest of all the papillae. Most individuals have only 8 to 12 of
this type of papillae. They are the taste buds for bitter. You can see them
at the base of the tongue. They have a red, risen appearance.
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THE TONGUE WITH A DEEP FISSURES
The fissures on the back of the tongue are normal structure;
There are individual differences in the number, location and their depth.
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FEATURES OF THE CHILD MUCOSA
• THERE IS A THIN LAYER;
• A BRIGHT RED BECAUSE OF A THIN EPITHELIUM;
• GREATER MITOTIC ACTIVITY;
• LESS KERATINIZED;
• MORE FRAGILE;
• WITH BETTER REGENERATIVE CAPABILITIES;
• IMMATURE CHILD IMMUNITY AFFECTS THE LOCAL AND
GENERAL, SPECIFIC AND NONSPECIFIC IMMUNE
MECHANISMS.