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Chapter 2

Anatomy and Oral Structures

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Skull

1- Cranium

2- Facial section

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Cranium ( KRAY-nee-um)

• That portion of the skull which encloses the brain

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Eight Cranial bones

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Facial Bones

• Fourteen bones, all paired on both sides, except one vomer in the nose and one mandible extending from right to left.

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1- Zygomatic

• (zye-goh-MAT-ick)

• Also called malar (MAY-lar) bones.

• Two bones under each eye giving form to the cheek bone.

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2- Maxilla

• (max-ILL-ah)

• Two facial bones one under each eye uniting in the center to form the upper jaw and support the maxillary teeth.

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3- Palatine

• (PAL-ah-tine)

• Two bones on both sides, forming the hard palate of the mouth and the nasal floor.

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4- Nasal

• (NAY-zal)

• Two bones on each side forming the arch of the nose.

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5- Lacrimal

• (LACK-rih-mal)

• Two bones each at the inner side of the orbital cavity.

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6- Inferior Nasal Conchae

• (KONG-kah) singular

• Two thin,scroll-like bones forming the lower part of the interior of the nasal cavity

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7- Mandible

• (MAN-dih-bul)

• The strong horseshoe-shaped bone forming the lower jaw.

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8- Vomer

• (VOH-mer)

• A single bone forming the lower posterior part of the nasal septum.

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Anatomical Features of the Skull

• 1- Sinuses

• 2- Bone structures

• 3- Processes of the skull bones

• 4- Major foramina

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Sinus

• An air pocket or cavity in the bone that lightens the bone, warms the air intake and helps form sounds. The four pairs of paranasal sinuses are:

• 1- Ethmoid

• 2- Sphenoid

• 3- Frontal

• 4- Maxillary

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Sutures of the mouth

• Unions of bones where the left and right bone pairs meet.There are four main sutures of the mouth:

• 1- Posterior nasal spine

• 2- Median palatine suture

• 3- Incisive suture

• 4- Nasion suture

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Posterior nasal spine

• (pos-TEE-ree-or)

• Located in the upper arch between the nasal bone and superior maxilla.

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Median palatine suture

• The union between the palatine bones.

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Incisive Suture

• (in-SIGH-siv)

• Located in the anterior area of the pre-maxilla and palatine processes.

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Nasion

• (NAY-zhun)

• A point where the nasofrontal suture is cut across by the middle plane of the skull.

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Process of the Cranium

• A projection or outgrowth of bone or tissue.

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Symphysis

• (SIM-fih-sis)

• Also called the mental or chin Protuberance.

• The projection in the center of the mandible forming the chin

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Eight processes of the mandible

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1- Alveolar

• (al-VEE-oh-lar)

• Bone growth or border of the maxilla and the mandible forming tooth sockets.

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2- Condyloid

• (KON-dih-loyd)

• Posterior growth on the ramus of the mandible articulating with the temporal bone in the temporomandibular joint(TMJ).

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3- Coronoid

• (KOR-oh-noyd)

• Anterior growth on the ramus of the mandible serving as the attachment position for the temporalis muscle.

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4- Frontal

• (FRON-tal)

• Projection of maxilla meeting with the frontal bone to form the eye orbit.

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5- Infraaorbital

• (in-frah-OR-bih-tal)

• Growth process from the zygomatic bone articulating with the maxilla to form the lower side of the eye orbit.

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6- Mastoid

• (MASS-toyd)

• Growth on the temporal bone behind the ear that is used for muscle attachment.

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7- Pterygoid

• (TER-ih-goyd)

• Meaning: wing-shaped

• Growth of the sphenoid bone extending downward from the bone.

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8- Styloid

• (STY-loyd)

• Small pointed growth from the lower border of the temporal bone serving as attachment for some tongue muscles.

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Foramina of the cranium

• (for-RAY—min-ah)

• The opening in the bone for nerve and vessel passage.

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Main foramina of head related to dentistry

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Magnum

• (MAG-num)

• Opening in the occipital bone for spinal cord passage.

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Mandibular

• (man-DIB-you-lar)

• Located on the lingual side of the ramus of mandible permitting nerve and vessel passage.

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Mental

• Latin for chin

• Opening situated on left and right anterior areas of the mandible for nerve and vessel passage.

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Lingual

• Small opening in the center of the mental spine for nerve passage to the incisor area.

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Incisive

• An opening in the maxilla behind the central incisors on the midline.

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Supraorbital

• An opening in the frontal bone above the eye orbit.

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Infraorbital

• An opening in the maxilla under the eye orbit.

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Palatine

• Anterior and posterior openings in the hard palate.

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Zygomaticofacial

• (zye-goh-MAT-ee-coe-fay-shal)

• An opening in the zygomatic bone.

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Oral Mucosa

g

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Periosteum

• (pear-ee-AHS-tee-um)

• The membrane forming a lining on all surfaces except areas of articulation.

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1- Lining Mucosa

• Mucous membrane that lines the inner surfaces of the lips (labial mucosa) and the cheeks(buccal mucosa).

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2- Masticatory mucosa

• (mass-TIH-kah-toe-ree)

• Elastic type of mucous membrane that undergoes stress and pull, around the alveolar area of the teeth and lines the hard palate.

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3- Specialized mucosa

• Smoother mucous tissue found on the dorsal side of the tongue.

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Landmarks and Features of the Mandible

• The only movable bone in the skull and the strongest in the face.

• Mandible has got seven major anatomical parts:

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1- Ramus

• (Ray-mus)

• Ascending part of mandible arises from the curved lower arch.

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2- Angle of the mandible

• Area along the lower edge of the mandible where the upward curve of the mandible forms.

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3- Sigmoid notch

• S-shaped curvature between the condyle and coronoid processes.

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4- Mylohyoid Ridge

• (my-loh-HIGH-oyd)

• Bony ridge on the lingual surface of the mandible.

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5- Oblique line

• (oh-BLEEK)

• Slanted bony growth ridge on the facial side of the mandible.

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6- Retromolar area

• The space located to the rear of the mandibular molars

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7- Mandibular notch

• The same as sigmoid notch.

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TMJ (TemporoMandibularJoint)

• The mandible articulates as a joint with Temporal bone commonly abbreviated as TMJ

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Glenoid

• Also called mandibular Fossa.

• The condyle of the mandible rests in a depression in the temporal bone called the GLENOID.

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Articular Disc

• It is located between the contact area of these two bones with a meniscus (men-IS-kus) and synovial (sin-OH-vee-al) fluid that cushions and lubricates the joint as it works in a hinge action movement.

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Muscles of Mastication

• Temporal

• Masseter

• Internal pterygoid

• External pterygoid

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1- Temporal

• Paired muscles that can elevate and lower the jaw and draw the mandible backward.

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2- Masseter

• (mass-EE-ter)

• The main mastication muscle that closes the mouth

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3- Internal Pterygoid

• Raises the mandible to close the jaw.

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4- External Pterygoid

Opens the jaw and thrusts the mandible forward, helps in lateral

movement.

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Trigeminal nerve (The Fifth Cranial Nerve)

• The most important nerve connected with dentistry that combines motor and sensory nerve, emerges from the brain and branches at the Gasserian (gas-AIR-ee-un) or semilunar Ganglion (GANG-lee-un).

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Trigeminal Nerve Divisions

• Ophthalmic

• Maxillary

• Mandibular

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1- ophthalmic

• (off-THAL-mick)

• A sensory nerve division with three branches.

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1- Lacrimal

• Providing sensation for lacrimal gland and eye conjunctiva.

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2- Frontal

• Provides sensation for the forehead, scalp, upper eyelid and nasal root.

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3- Nasocilliary

• (nay-zoh-SIL-ee-air-ee)

• Provides sensation for nose, eye and eyebrow.

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2- Maxillary

• A sensory division of the trigeminal nerve with several branches:

• Anterior palatine

• Middle palatine

• Posterior palatine

• Nasopalatine

• Infraorbital ----=> Anterior – Middle- Posterior

• Zygomatic

• Sphenopalatine

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3- Mandibular

• Mixed nerve division that registers sensation and causes movement. It has six branches:

• Inferior Alveolar

• Mylohyoid

• Mental

• Incisive

• Lingual

• Buccal

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The major Blood Supply vessels to the head

• Carotid artery

• Jugular vein

• Capillaries

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Carotid Artery

• (care-OT-id)

• Rises from the aorta right and left and divides in the neck to form two arteries:

• Internal carotid and external carotid

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Jugular vein

• (JUG-you-lar)

• Transports blood from the head to the heart.

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Capillaries

• (KAP-ih-lair-eez)

• Tiny blood vessels that help transport blood from the veins to the arteries.

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Salivary Glands

• 1- supply secretion to oral cavity

• 2- Protect the lining of mouth

• 3- Help moisten food

• 4- Assist in speech

• 5- Make saliva to expectorate

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Major Salivary Glands

• Parotid

• Submandibular

• Sublingual

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Parotid

• The largest salivary gland, located near the ear, producing serus saliva which empties into the mouth near the maxillary second molar and via Stenson’s duct.

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Submandibular

• A smaller gland on the lower side of the face secreting mucin and serus fluid with enzymes, empties through Wareton’s (or submandibular) duct opening under the tongue on both sides of lingual frenum.

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Sublingual

• Smallest salivary glands in the floor of mouth secreting mucin via multiple ducts

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Important Structures in the Oral Cavity

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Labia

• (LAY-bee-ah)

• Lips have several sections.

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Superior Oris

• Upper lip.

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Inferium Oris

• Lower lip.

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Labial Commissure

• (Kom-ih-shur)

• Area at the corners of the mouth where the lips meet.

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Vermilion Border

• (ver-MILL-yon)

• Area where the pink red lip tissue meets the facial skin.

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Philtrum

• (FIL-trum)

• Median groove in the center external surface of the upper lip.

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Caruncle

• (CAR-unk-ul)

• Small fleshy mucous tissue elevations under the tongue.

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Frenum

• (FREE-nah) plural form

• The tongue and each lip and cheek attach to the oral membrane with a triangular piece of tissue called a Frenum.

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Major Frena of Oral Cavity

• Labial frenum

• Lingual frenum

• Buccal frenum

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Labial Frenum(2)

• Tissue attaching the inside of the lip to the mucous membrane in the anterior of the oral cavity.

• Both in maxillary and mandibular arches.

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Frenectomy

• The maxillary labial frenum is the common site for maxillary frenectomy.

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Lingual Frenum(1)

• Attaches the lower side of the tongue to the floor membrane.

• Openings to Wharton’s duct are on each side of this frenum.

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Ankyloglossia

• (ang-key-loh-GLOSS-ee-ah)

• If the lingual frenum is too short ankyloglossia, a tongue-tied condition can result.

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Buccal Frenum(2)

• Attaches the inside of the cheek to the oral cavity in the maxillary first molar area on both sides.

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Tongue

• Also called Glossa

• A strong muscular organ that aids in chewing, talking and deglutition.

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Tongue Structures

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Median Sulcus

• (SULL-kus)

• Divides the tongue’s top surface into two parts

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Papillae

• (pah-PIH-lie)

• Taste buds situated on the dorsal surface of the tongue.

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Circumvallate

• The largest V-shaped papillae, situated on the dorsal aspect ot the tongue. Sense bitter tastes.

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Filiform

• (FIL-ih-form)

• The smallest, hair-like papillae covering the entire aspect of the tongue. Do not sense taste .

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Fungiform

• Small, dark-red papillae on the middle and anterior dorsal surface and along the sides of the tongue. Sense sweet, sour and salty taste.

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Foliate

• (FOE-lee-ate)

• On the posterior lateral borders of the tongue and can be seen if the tongue is grasped with gauze and extended. Sense sour tastes.

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Palate Structures

• Divided into two main divisions:

• Hard palate

• Soft palate

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Hard Palate

• Composed of palatine processes of maxillae bones, covered with mucous membrane and has rugae (RUE-guy), irregular folds or bumps on the surface.

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Incisive Papilla

• Tissue growth situated at the anterior portion of palate behind the maxillary centrals.

• The site for infiltration injection anesthesia.

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Palatine Raphe

• (RAH-fay)

• White streak in the middle of the palate.

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