Oral cavity

1
Oral cavity
2
Oral cavity general anatomy

• Structure
• Vestibulum
• Teeth arcades
• Teeth
• Lips
• Cheeks
• Oral cavity proper
• Roof (hard soft palate)
• Floor
• Tongue

3
General histologic structure

• Oral mucosa
• Epithelium stratified squamous either non- ,
  para- or (ortho-)keratinizing
• Basal lamina
• Lamina propria loose or dense irregular
  connective tissue
• Submucosa loose connective tissue with small
  (minor) salivary glands, adipose tissue

4
General histologic structure

• Muscular layer striated muscle fibers
• Deep structures bone, skin, respiratory mucosa

5
Oral mucosa types

• Lining (covering) mucosa
• Masticatory mucosa
• Specialized mucosa

6
Lining mucosa

• Location
• cheeks
• lips
• alveolar mucosa
• mouth floor
• ventral face of the tongue
• soft palate

7
Lining mucosa

• Mucosa
• Non-keratinizing stratified squamous epithelium
• basal layer
• intermediate layer
• superficial layer
• Other cell types
• melanocytes basal layer
• Langerhans cells
• Merkel cells
• intraepithelial lymphocytes

8
Lining mucosa

• Lamina propria
• loose connective tissue
• blood lymph vessels
• free nerve endings and Meissner corpuscules
• papillae
• rare and shallow

9
Lining mucosa

• Submucosa
• loose connective tissue
• collagen fibers
• elastic fibers
• minor salivary glands
• cheeks, tongue, lips, soft palate
• tubuloacinary serous, mucous, mixt
• blood vessels, nerves
• isolated sebaceous glands (Fox-Fordyce)
• is absent on the ventral face of the tongue

10
Palat moale, col. HE
11
Masticatory mucosa

• Location
• gums
• hard palate
• Mucoasa
• Keratinizing or para-keratining stratified
  squamous epithelium
• basal layer
• spinous layer
• granular layer
• superficial layer

12
Masticatory mucosa

• Lamina propria
• papillary layer
• frequent and deep papillae
• blood vessels, nerve endings
• reticular layer
• dense irregular connective tissue
• gums collagen fibers insert into the alveolar
  bone periosteums

13
Masticatory mucosa

• Submucosa
• only in the hard palate
• anterior adipose tissue
• posterior minor salivary glands, continuous
  with the submucosal layer of the soft palate

14
Hard palate, HE stain
15
Specialized mucosa

• Location
• Dorsal face of the tongue
• Lingual papillae and taste buds

16
Lips

• Muscle connective tissue core
• striated muscle fibers orbicular muscles
• minor salivary glands
• fat cells
• blood vessels nerve fibers

17
Lips

• External side - skin
• Keratinizing stratified squamous epithelium -
  epidermis
• Dermis with
• Sweat and sebaceous glands
• Hair follicles
• Fox-Fordyce granules
• Internal side
• lining oral mucosa
• Vermillion
• Keratinizing stratified squamous epithelium -
  thin
• abundant blood vessels

18
Lip, HE
19
Cheeks

• External face skin
• Internal face lining oral mucosa
• submucosa numerous minor salivary glands
• adipose tissue, sometimes lobulated Bichat fat
  bubble
• adherent to masticatory muscles via dense
  irregular connective tissue

20
Cheeks

• Juxtaoral organ of Chievitz
• medial from the ascending branch of the mandibule
• islands (nests) of squamous epithelial cells in a
  dense connective tissue stroma
• free nerve endings
• proposed functions neuroendocrine, sensory

21
Juxtaoral organ of Chievitz
22
Palate uvula

• Hard palate
• masticatory mucosa with fixed folds
• Soft palate
• oral face with NKSSE
• pharynx face with respiratory epithelium -
  pseudostratified ciliated columnary
• striated muscle fibers
• Uvula
• similar to the soft palate

23
Tongue

• Muscular core
• striated muscle fibers with perpendicular
  orientation
• belong to extrinsic muscles (genioglossal,
  hyoglossal) and intrinsic (lingual)
• interspread minor salivary glands , adipose
  cells, numerous blood vessels, nerve fibers
• Ventral face
• lining oral mucosa,
• Dorsal face
• specialized mucosa

24
Tongue, HE, 40x
25
Tongue dorsal face

• Anatomy
• base, separated by
• the tongue V-ul (sulcus terminalis) from
• the body and tip of the tongue
• foramen cecum remnants of the thyreoglossal
  canal

26
Tongue dorsal face

• Base of the tongue (posterior)
• NKSSE
• crypts
• ligual tonsils diffuse and nodulare lymphoid
  tissue
• prominent

27
Tongue dorsal face

• Lingual papillae
• Projections of the tongue surface with a
  connective tissue core
• Types
• Filiform
• Fungiform
• Foliate
• Circumvallate

28
Tongue lingual papillae

• Filiform p.
• Numerous, conical
• Keratinizing SSE
• No taste buds

29
Tongue lingual papillae

• Fungiform p.
• Isolated, spread among filiform p.
• Connective tissue with abundant blood vessels
• Rare taste buds

30
Tongue lingual papillae

• Foliate p.
• On the lateral edges of the tongue, perpendicular
  to the long axis
• Connective tissue core, blood vessels
• Contain taste buds, more frequent in young persons

31
Tongue lingual papillae

• Circumvallate p.
• 8 -12
• 0,1 0,2 cm in diameter
• surrounded by a deep cleft (vallum)
• von Ebner salivary glands
• Very frequent taste buds

32
Taste buds

• Oval (barrel) - shaped 80 x 50 mm
• Taste pore
• Cells
• sensory (neuroepithelial) cells
• support
• basal

33
Taste buds

• Location
• About 250 / circumvalate p.
• P. fungiform, p. foliate
• Glossopalatal arches, soft palate
• posterior face of epiglottis
• Posterior wall of the pharynx
• Sensory innervation
• cranial nerves VII and IX
• Subgemmal, perigemmal and intragemmal nerve plexa

34
Taste buds

• Function taste perception
• sweet
• sour
• bitter
• salty

35
Tongue nerve supply

• Motor hypoglossal n. (XII)
• General sensitivity
• anterior 2/3 n. V
• posterior 1/3 n.IX
• Sensorial
• anterior 2/3 n. VII
• posterior 1/3 n.IX

36
Teeth

• Temporary (decidual) teeth
• 20 teeth
• 2i, 1c, 2m
• Definitive dentition
• 32 teeth
• 2i, 1c, 2 pm, 3m

37
Tooth general structure
38
Tooth pulp

• Tooth pulp
• Young connective tissue (mesenchymal),
  originating from the dental papilla
• Stellate cells, with long, branching processes
• other cells lymphocytes, plasma cells,
  macrophages, eosinophils
• PAS ground substance, jelly-like
• Blood vessels and nerve fibers
• Weil space area without cells, with von Korff
  collagen fibers that extend into the dentin
• odontoblasts

39
Dentin

• Inorganic component (70)
• Hydroxyapatite crystals
• Growth lines von Ebner (thin), Owen (thick)
• Dentin tubules (Tomes canallicles)
• Czermak spaces (interglobulary)
• Organic component (30)
• Extracellular matrix (collagen, GAG)
• Cells odontoblasts

40
Sir John Tomes (1815-1895) Kings College
Hospital, Londra
41
Anton Gilbert Victor von Ebner, Ritter von
Rosenstein (1842-1925) profesor, Universitatea
din Viena, 1888-
42
Johann Nepomuk Czermak (1828-1873) profesor,
Universitatea din Leipzig
43
Dentin

• Odontoblasts
• Produce secrete predentin organic matrix of
  the dentin
• One cell layer that lines the tooth pulp. Cells
  establish tight junctions

44
Dentina - continuare

• Odontoblasts
• Columnar cells with secretory granules, abacus
  bodies
• Procese odontoblastice apicale (fibre Tomes) cu
  microtubuli, microfilamente, granule de secretie

45
Smaltul

• Componenta anorganica (98)
• Cristale de hidroxiapatita
• Cea mai dura substanta din organism
• Compus din prisme adamantine si substanta
  interprismatica
• Liniile Retzius - mineralizare

46
Smaltul

• Prismele sunt curbate, în forma de S (-gt liniile
  Hunter-Schreger)
• Tufele smaltului, la jonctiunea smalt-dentina
• Cariile dentare zone de demineralizare

47
John Hunter (1728-1793)
48
Carl Gustav Retzius (1842-1919) Institutul
Karolinska, Stockholm
49
Anders Retzius (1796-1860) Institutul Karolinska,
Stockholm
50
Smaltul - continuare

• Componenta organica (2) matrice extracelulara
• Proteine specifice smaltului
• amelogenina (numai în smaltul în formare)
• enameline proteaze
• proteinele tufelor
• Produsa de adamantoblaste (enameloblaste) în
  cursul histogenezei dintelui

51
Histogeneza dintelui faza de mugure
Lamina dentala

• Invaginare a epiteliului primitiv

Condensarea ectomezenchimului
52
Histogeneza dintelui faza de cupa
epiteliul extern reticul stelat epiteliu intern
Organulsmaltului
papila dentara
53
Histogeneza dintelui faza de clopot
Lamina succesoriala
Strat intermediar
54
Histogeneza dintelui faza de mugure

• Ameloblaste
• Secretorii
• celule înalte, cilindrice
• procese apicale
• RER, granule de secretie
• De maturare
• caractere ultrastructurale ale celulelor
  epiteliale de transport

55
Periodontiul

• Cement
• Ligamentul alveolo-dentar
• Osul alveolar
• Gingia

56
Cementul

• Cement
• substanta similara osului
• componenta anorganica (40-50)
• componenta organica
• tipuri
• acelular
• celular cementocite în cementoplaste
• nu este vascularizat
• nu formeaza sist. Havers

57
Ligamentul periodontal

• Tesut conjunctiv dens
• fibre colagen ce solidarizeaza cementul de
  periost
• fibre oxitalanice
• fibroblaste
• Tesut conjunctiv lax
• grupat în insule
• bine vascularizat (asigura si nutritia cementului)

58
Ligamentul periodontal - continuare

• Insule epiteliale Malassez
• Functii lig. periodontal
• ancorare, suport, mobilitate
• remodelare os
• nutritie cement
• proprioceptie

59
Alveola dentara

• Os alveolar
• compact insertia lig. periodontal
• spongios
• Os de sustinere
• în profunzime
• os lamelar

60
Gingia

• Mucoasa orala masticatorie
• EPS(P)K
• Sant gingival
• Membrana bazala se ataseaza de smalt dispozitiv
  de atasare epiteliala