oral mucosa...2020/10/09  · oral mucosa is a part of an oral biological system mo, food, air mo,...

ORAL MUCOSAHISTOGENESIS, MORPHOLOGY AND PHYSIOLOGY OF

THE ORAL MUCOSA AND GINGIVA. FEATURES IN

CHILDHOOD.

Assoc. Prof. Dr N. Mitova

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.

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.

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

HISTOGENESIS OF THE ORAL MUCOSA

From the primary ectoderm;

From the primary mesoderm.

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.

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.

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.

STRUCTURE OF ORAL MUCOSA

The oral cavity is lined with stratified epithelium, which is divided into three types:

• Lining mucosa;

• Masticatory mucosa;

• Specialized mucosa.

LINING MUCOSA

• LINING MUCOSA –

COVER THE FLOOR OF

THE MOUTH AND THE

CHEEKS, LIPS, AND SOFT

PALATE;

MASTICATORY MUCOSA

• IT COVERS THE HARD

PALATE AND ALVEOLAR

RIDGES;

SPECIALIZED MUCOSA

• WHICH COVERS THE

SURFACES OF THE

TONGUE.

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.

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,

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.

SCHEME OF AN ORAL MUCOSA

• PAPILLARY FOLDS;

• MULTILAYERED

EPITHELIUM;

• BASAL LAMINA;

• LAMINA PROPRIA:

• LAMINA LUCIDA;

• LAMINA DENSA;

• SUBMUCOSA

DIFFERENT TYPES OF MUCOSA

прикрепенаattached

Специализирана -по езика

Free

Specialized

EACH TYPE OF TISSUE HAS STRUCTURAL DIFFERENCES

• THE LINING MUCOSA IS:

• SOFT;

• PLIABLE;

• NONKERATINIZED.

MASTICATORY MUCOSA:

• IS KERATINIZED;

• INDICATIVE OF THE

ATTRITION, THAT TAKE

PLACE DURING

MASTICATION.

SPECIALIZED MUCOSA:

• THIS IS THE MUCOSA OF THE TONGUE SURFACE;

• IT IS COMPOSED LARGELY OF CORNIFIED EPITHELIAL PAPILLAE;

• THEY ARE FUNCTIONING IN MASTICATION.

LAYERS OF EPITHELIUM

• STRATUM CORNEUM

• STRATUM GRANULOSUM

• STRATUM SPINOSUM

• STRATUM BASALE

(GERMINATIVUM)

KERATANIZED EPITHELIUM

There is a pronounced papillary layer;

It lacks submucosa;

You can see the 4 epithelial layers.

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.

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.

CELLS OF THE SQUAMOUS EPITHELIUM

The basal cells gradually

migrate to the surface of the

mucosa and undergoes

changes.

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.

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.

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;

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.

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.

• 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.

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.

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.

Structure of the basement membrane

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

COHESION - BY DESMOSOMES

ADHESION – BY HEMIDESMOSOMES

FOCAL CONTACTS - BY TRANSMEMBRANEPROTEINS

Gap-links - produce holes between cells

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 ;

SUBMUCOUSE

Laminapropria:

• Papillary layer;

• Reticular layer

Submucosa.

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.

COLLAGEN FIBERS

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.

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.

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.

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.

DEGREE OF KERATINIZATION

nonkeratinized

keratinized

Specialized with areas

with a different

keratinization

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;

• 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.

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.

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).

JUNCTIONALEPITHELIUM

• IT PROVIDES ATTACHMENT

FOR THE GINGIVA TO THE

TOOTH IN THE CERVICAL

AREA AND FORMS THE

EPITHELIUM-LINED FLOOR

OF THE GINGIVAL

SULCUS;

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.

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

• 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.

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.

MARGINAL GINGIVA

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;

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.

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.

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.

PALATAL MUCOSA

KERATINIZED EPITHELIUM OF THE HARD PALATE

STRATUM GRANULOSUM OF THE HARD PALATE

SLOUGHED EPITHELIAL CELLS

The surface of the epithelium is a subject to constant renewal

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.

NONKERATINIZED EPITHELIUM

Surface epithelial layer is denser.

TYPES OF LINING MUCOUSA

• SUBDIVIDED INTO MUCOUSA OF THE:

• LIPS;

• SOFT PALATE;

• CHEEKS;

• FLOOR OF THE MOUTH;

• VENTRAL SURFACE OF THE TONGUE;

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.

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.

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.

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.

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.

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.

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.

THE TONGUE

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.

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.

FILIFORM PAPILLAE

FILLIFORM PAPILLA

FOLIATE PAPILLAE, MUSCLES, BLOOD VESSELS

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.

FUNGIFORM PAPILLAE

Red, raised structures;

Covered with nonkeratinized epithelium;

Are scattered between filiform papillae;

They have taste buds at the surface.

FUNGIFORM PAPILLAE

FUNGIFORM PAPILLAE

CIRCUMVALLATE PAPILLAE

V-shaped

CIRCUMVALLATE PAPILLA WITH THE TASTE BUDS

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.

BLOOD SUPPLY AND INNERVATION OF THE TASTE BUDS

TASTE BUDS INCIRCUMVALLATE PAPILLA

PORES OF TASTE BUDS

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.

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.

FOLIATE PAPILLAE

At the back of the tongue

Behind circumvallatepapillae.

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.

LINGUAL TONSILS

PLICA FIMBRIATA

A linear projection of the ventral surface of the tongue;

Sometimes is brown.

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.

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.

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.