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WenChen Wang
學習目標• 口腔黏膜的分類、定義與功能• 口腔黏膜的細胞組成及顯微構造
學習資源及主要圖片引用 : 1. Nanci A: Ten Cate’s Oral Histology, Develop
ment, structure, and function 6th ed. p.329-75 2. Orban BJ :Orban’s oral histology and embryology,9th ed. p.261-3343. Avery JK: Essentials of Oral Histology and Emb
ryology: A clinical approach. 2nd ed. p.164-83
WenChen Wang
MUCOUS MEMBRANEDefinition:
-Moist lining of the intestinal tract, nasal passages and other body cavities that communicate with the exterior
Oral mucosa
Oral mucosa: Oral mucous membrane
WenChen Wang
各部位的口腔黏膜
上下唇－唇紅緣 vermillion border唇黏膜 labial mucos
a唇繫帶 labial frenum前庭區 vestibule
WenChen Wang
頰－頰黏膜 buccal mucosa
頰繫帶 buccal frenum
咬合線 occlusal line
腮腺開口 orifice of Stenson’s duct
WenChen Wang
舌－ 口底－舌背 唾液腺開口
dorsal surface
舌腹ventral surfrace
舌繫帶lingual frenum
舌側緣tongue border
WenChen Wang
牙齦－齒間牙齦interdental papilla固著牙齦attached gingiva黏膜牙齦mucogingiva前庭區
WenChen Wang
顎部－硬顎 hard palate
軟顎 soft paalte
懸雍垂 uvula
WenChen Wang
FUNCTIONS OF ORAL MUCOSA
• Protection
• Sensation
• Secretion
• Thermal regulation
Oral mucosa
WenChen Wang
STRUCTURE OF ORAL MUCOSA
• Epithelium………………
..epidermis
• Lamina propria………
..dermis• Submucosa……………
..subcutaneous
* Epithelial ridges, rete pegs
Oral mucosa
WenChen Wang
Oral mucoperiosteum
WenChen Wang
EPITHELIUM
…stratified squamous cell
Keratinized Nonkeratinized basal basal prickle prickle granular intermediate keratinized superficial
Oral mucosa
WenChen Wang
KeratinizationBasal cell prickle granular keratinized layer
WenChen Wang
Basal cell layer
• Cuboid or columnar shape• Containing bundles of tonofibril
s and cell organs• Synthesize DNA, protein• Most cell divisions
Oral mucosa
WenChen Wang
Prickle cell layer (spinous cell layer)
• Irregularly polyhedral shape• Conspicuous tonofibril bundles• Membrane-coating granules in uppe
r part• Intercellular bridge- Desmosome• Most active in protein synthesis
Oral mucosa
WenChen Wang
Granular cell layer
• Flatter & wider• Keratohyaline granules• Tonofibrils• Membrane-coating granules• Synthesis protein
Oral mucosa
WenChen Wang
Keratin layer• Flattened & dehydrated• Lost all organelles• Cell filled with packed fibrillar material
Oral mucosa
orthokeratin parakeratin
WenChen Wang
Intermediate layer of nonkeratinized epi. • Flattened cells • Tonofilaments & glycogen
Superficial layer of nonkeratinized epi.• Flattened cells • Tonofilaments
& glycogen• Fewer organells• Nuclei persist
Oral mucosa
WenChen Wang
Nonkeratinocytes in the oral epi.• Melanocyte melanin, premelanosome, melanosome• Langerhan’s cell regulatory, antigen trap• Merkel’s cell tactile sensory• Lymphocyte inflammatory response
**Clear cells: Melanocyte, Langerhan’s cell, Merkel’s cell
Oral mucosa
WenChen Wang
Intercellular Junctions• Desmosome (Hemide
smosome)• Tight junction• Gap junction
Oral mucosa
Intercelluar bridge
WenChen Wang
FUNCTIONAL CLASSIFICATION
OF ORAL MUCOSAKeratinized areas• Masticatory mucosa-hard palate & gingiva• Vermilion border
Nonkeratinized areas…Lining or reflecting mucosa• lip, cheek, alveolar mucosa, vestibular fornix, m
outh floor, soft palate, ventrum of tongue
Specialized mucosa• dorsum of the tongue
Oral mucosa
WenChen Wang
Hard Palate1.different zones of palatine mucosa
gingival region, palatine raphae, fatty zone, glandular zone(mucous gland)
Oral mucosa
WenChen Wang
2. tight fixed to the underlying periosteum
* No submucous layer: gingiva region and palatin raphe (mucoperiosteum)
3. epithelium uinform in form, well-keratinized
WenChen Wang
Gingiva
1. Parakeratinized 75%, orthokeratinized 15%, nonkeratinized 10%
2. often showing stippled surface
Oral mucosa
WenChen Wang
3. Free gingiva, free gingiva groove, attached gingiva, interdental gingiva, mucogingival junction
4. “col”…depressed part of interdental papilla, thin nonkeratinized epi.
WenChen Wang
Vermilion border of lip• Transitional zone between skin
of lip and lip mucosa
• No gland
Oral mucosa
WenChen Wang
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
Oral mucosa
WenChen Wang
Fordyce’s spots (granule)
• Isolated sebaceous gland
• buccal mucosa near mouth angle and opposite the molars
Oral mucosa
WenChen Wang
Fordyce’s granule
WenChen Wang
Specialized Mucosa
… Dorsal lingual mucosa
• Lingual PapillaeFiliform papilla: entire an
t part of tongue, no taste bud
Fungiform papilla: tongue tip
Foliate papilla: lateral border of post. Tongue
Oral mucosa
WenChen Wang
Circumvallate papilla: before V-shape terminal sulcus, 8-10 in number
• von Ebner’s glands, main source of salivary lipase
WenChen Wang
Foliate papilla
Fungiform papilla
Circumvallate papilla
WenChen Wang
Taste Buds1. Ovoid or barrel-shaped intraepi. organ2. Taste pore3. Supporting cells4. 10-12 neuroepithelial cells (receptors of taste)
Oral mucosa
WenChen Wang
WenChen Wang
Taste Sensation
• Sweet-fungiform papilla
• Salty-fungiform
• Bitter -circumvallate
• Sour- foliate
Oral mucosa
WenChen Wang
SummaryORAL MUCOSA
• STRUCTURE OF ORAL MUCOSAKeratinized vs. NonkeratinizedKeratinocytes in the oral epiNonkeratinocytes in the oral epi
• FUNCTIONAL CLASSIFICATIONKeratinized areasNonkeratinized areasSpecialized mucosa
WenChen Wang
SALIVARY GLANDSALIVARY GLAND
Salivary gland
唾 液 腺
WenChen Wang
學習目標• 唾液腺的分類、組織與細胞組成及功能
學習資源及主要圖片引用 :1. Avery JK. Oral development and histology. 2nd e
dition, Chapter 21, p. 352-812. Berkovitz BK, Holland GR, Moxham BH. 2nd editio
n, p.215, 2203. de Almeida PDV, et al.. Saliva Composition and F
unctions: A Comprehensive Review. J Contemp Dent Pract 2008 3:72-80
WenChen Wang
CLASSIFICATION OF SALIVARY GLAND
1. By location
2. By sizeMajor Salivary Gland
Parotid gland Submandibular gl. Sublingual gland
Minor Salivary Gland Labial and buccal, palatine, lingual……
Salivary gland
WenChen Wang
CLASSIFICATION OF SALIVARY GLAND
3. By structure:Mucous glandSerous glandMixed gland
Salivary gland
WenChen Wang
STRUCTURE OF SG
• Acinus cells• Duct system • Connective tissue:
fibrous septa and capsule
blood vesselsnerves
Salivary gland
WenChen Wang
• acinic cellsmucous cell , serous cell or mixed acin
i
• Terminal tubule:
acinic cell +
myoepithelial cell• Terminal secretory units:
Terminal tubule+
intercalated duct cell
WenChen Wang
Mucous cell
• pale• Low-protein, high c
arbohydrate• Mucin: glycoprotei
n, sialic acid• Viscous• Lubrication
Salivary gland
WenChen Wang
Serous cell
• Dark stain• High -protein, low car
bohydrate• rER, lysosome, mitoc
hondria, secretory granule, zymogen granules (amylase)
• Watery consistency• Digestion
Salivary gland
WenChen Wang
Myoepithelial cell
• Surrounding the acinic cell and intercalated duct
• Long process• like smooth m. in ult
rastructure• Contractile function,
helping to extraction
Salivary gland
WenChen Wang
• Demilunes: mixed acini muco
us cells (inner) + serous cells
• Cell Junctions:• Tight junction
Intermediate junction
Desmosome characteristics of ectodemal origin
Salivary gland
WenChen Wang
SALIVA produced by terminal secretory units
striated duct
interlobular duct
excretory duct
main duct (ex. Stensen’s duct)
ORAL CAVITY
Salivary gland
MAJOR SALIVARY GLAND
WenChen Wang
Parotid gland• Size largest• Location retromandibular fossa,
infra-auricular• Main duct Stensen’s duct• Opening buccal mucosa respect to 2nd
molar• Acini serous acini• Saliva Vol. 25-30%
Salivary gland
WenChen Wang
Submandibular gland
• Size intermediate
• Location submandibular triangle,
below mylohyoid m.
• Main duct Warton’s duct
• Opening Caruncula sublingualis,
mouth floor
• Acini mixed acini, serous
predominate
• Saliva Vol. 60%
Salivary gland
WenChen Wang
Sublingual gland
• Size smallest ( a main gland and
several small glands)• Location mouth floor,
above mylohyoid m.• Main duct Bartholin’s duct• Opening sublingual fold• Acini mixed acini, mucous
predominate• Saliva Vol. 5%
Salivary gland
WenChen Wang
MINOR SALIVARY GLANDS
about 7% of total saliva
• Labial and buccal (mixed)
• glossopalatine (pure mucous)
• palatine (pure mucous)
• lingual (mixed)
Salivary gland
WenChen Wang
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
Salivary gland
SALIVA : COMPOSITION AND FUNCTION
• Lumbrication ...mucins, proline-rich proteins• Buffering ………………………….bicarbonate• Remineralization ………...calcium , phosphate• Digestion……………amylase, lipase, proteases• Antimicrobial property ...proline-rich proteins,
lysozyme, histatins, lactoperoxidase, IgA• Protection………………………. water, mucins• Wound healing………………... growth factors
Homeostasis of Oral Cavity
Salivary gland
WenChen Wang
COMMON CAUSES of salivary dysfunction
• Aging• Infection, inflammation, obstructio
n• Side effects of drugs• Autoimmune disease (ex. Sjögren’s
syndrome)• Diabetes Mellitus, alcoholism• Neoplasm• Head and neck Radiotherapy
Salivary gland
WenChen Wang
DENTAL COMPLICATIONS related to salivary dysfunction
• Xerostomia
• Rampant caries
• Periodontitis
• Secondary infection
Salivary gland
WenChen Wang
Summary
SALIVARY GLAND• CLASSIFICATION
By location, size & structure
• STRUCTUREConnective tissueDuctsTerminal secrectory units
• SALIVA : COMPOSITION AND FUNCTION
• CLINICAL CONSIDERATION
