ORAL MIC ANA LAB (March 4) ORAL MUCOSA MUCOUS MEMBRANE Moist lining of the intestinal tract nasal

l passages, and other body cavities that communicates with the exterior ORAL MUCOUS MEMBRANE OR ORAL MUCOSA Moist lining of the oral cavity At the lips, the oral mucosa is continuous with the skin At the pharynx, it is continuous with the lining of the rest of the intestine MAIN TYPES OF ORAL MUCOSA Masticatory Mucosa Lining Mucosa Specialized Mucosa Masticatory Mucosa Has keratinized epithelium because it is subjected to abrasive forces such as biting, grinding and moving the ingested food in the oral cavity Includes: o Gingiva o Hard palate

Acts as a major barrier from the mechanical forces (seizing, biting, chewing of food and surface abrasion from hard particles in the diet), from which the oral soft tissues are exposed

Sensation The receptors of the mouth respond to temperature, touch, pain and taste (taste buds) Certain receptors respond to the taste of water and signal the satisfaction of thirst Reflexes of swallowing, gagging, retching, and salivating (acidic foods) are also initiated by receptors Secretion The major secretion associated with oral mucosa is saliva. It contributed to the maintenance of a moist surface. Sebaceous glands are present but their secretions are insignificant Permeability and Absorption The thinnest epithelial region, the floor of the mouth, may be more permeable than other areas Certain drugs such as nitroglycerin (administered to relieve angina pectoris) are successfully absorbed when held under the tongue (sublingual) Thermal Regulation In some animals, the mucosa plays a major role in thermal regulation by dissipating heat through the oral mucosa by panting. In humans, the oral mucosa plays no role in regulating body temperature HISTOLOGIC CHARACTERISTICS OF ORAL MUCOSA Consists of two layers 1. Surface Epithelium a. Keratinized o Orthokeratinized - fully keratinized o Parakeratotic - incompletekeratinization or hornified b. Non-Keratinized 2. Lamina Propria a. Papillary Layer b. Reticular Layer SURFACE EPITHELIUM Keratinized Epithelium (Layers) Keratinous Layer or Statum Corneum (outermost) Granular Layer or Stratum Granulosum Prickle Cell or Stratum Spinosum Basal Cell Layer or Stratum Basale Basal Lamina Basement Membrane or Membrana Propia (innermost) Non-Keratinized Epithelium (Layers) Superficial Layer (Stratum Superficiale) Intermediate Layer (Stratum Intermedium) Basal Cell Layer (Stratum Basale) * no Stratum Corneum and Stratum Granulosum LAMINA PROPRIA Papillary Layer Connective tissue papilla Connective tissue layer that indents the epithelium Maybe short or absent in some mucosa Reticular Layer Consists of densely arranged connective tissue fibers (reticular) CLINICAL FEATURES OF ORAL MUCOSA 1. Oral mucosa is more deeply colored than skin, most obviously at the lips Factors Affecting Coloration a. Concentration and state of dilation of small blood vessels in the underlying connective tissue (more blood vessels = red) b. Thickness of the epithelium (thicker = lesser color) c. Degree of keratinization (less keratin = darker color) d. Amount of melanin in the epithelium (more melanin = darker)

Gingiva

Hard Palate.

Lining Mucosa Non-keratinized epithelium\ Act as protective lining of the more sheltered areas Includes: o Those firmly attached to the underlying bone, fascia, or muscles o Those loosely attached to the underlying bone, fascia or muscle Firmly Attached Lining Mucosa (covering of the...) Soft palate Lips Cheeks Inferior surface of the tongue Tonsils Loosely Attached Lining Mucosa Alveolar Mucosa Vestibular Mucosa Mucosa of the floor of the mouth (sublingual sulcus) Specialized Mucosa Rough and irregular because of protruding papillae Possess taste buds Includes: o Dorsum of the tongue Anterior 2/3 (masticatory) Posterior 1/3 (lining) FUNCTIONS OF THE ORAL MUCOSA Protection Sensation Secretion Permeability and absorption Thermal regulation Protection As a surface lining, it separates and protects deeper tissues and organs in the oral region from the environment of the oral cavity

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Color gives an indication as to the clinical condition of the mucosa (inflamed tissues are red, normal tissues are a paler pink) - gingival inflammation Oral mucosa has a moist surface and there is absence of appendages (hairs and nails) a. Glandular components of oral mucosa is primarily the minor salivary glands b. Sebaceous glands are present in the upper lip and buccal mucosa in about 3/4 of adults, found in alveolar mucosa and dorsum of the tongue, they appear as pale yellow spots called Fordyce's Spots Surface of oral mucosa is smoother and have fewer folds or wrinkles than the skin, but topographic features are apparent, such as the different papillae on the tongue, rugae of hard palate, and stippling (small pinpoint holes) pattern of the gingiva (attached gingiva) Oral mucosa varies considerably in its firmness and texture a. The gingiva and hard palate are covered by a firm immobile layer which is important in clinical implications when it comes to giving local injections of anesthetics or taking biopsies of the oral mucosa

MUCCOGINGIVAL JUNCTION (MGJ) Separates the attached gingiva from the alveolar mucosa ALVEOLAR MUCOSA It present only in the vestibular region It extends from the muccogingival junction to the vestibular fornix, where it is continuous with the mucosa covering the lips and cheeks It is movable, can be lifted to a limited extent from its base It is deep red in color It has a smooth surface DENTOGINGIVAL JUNCTION The interface between the gingiva and the tooth surface Characterized by 2 attachment o Epithelial Attachment o Connective Tissue Attachment Epithelial Attachment Attached epithelial cuff Part of the gingival epithelium attached to the surface of the tooth Consisting of 3-4 layers of cells but gradually increase to about 10-20 rows of cells as age advances Broken when separating gum from tooth structure (using gum separator) Connective Tissue Attachment The fiber bundles of the gingival connective tissue that insert into the supraalveolar cementum Occurs between the crest of the alveolar bone or Interdental bony septum and cemento-enamel junction FUNDAMENTAL COMPARTMENTS OF THE DENTINOGINGIVAL JUNCTION Junctional epithelium Oral Sulcular Epithelium (sulcus) Oral Gingival Epithelium (outermost) Junctional Epithelium Epithelial part of the free gingiva not visible from outside Forms a collar around the neck of the tooth on the cervical enamel Forms and supports the epithelial attachment and is continuous with the oral sulcular epithelium Oral Sulcular Epithelium Lines the lateral wall of the gingival sulcus Continuous with the occlusal end of the junctional epithelium and with the oral gingival epithelium occlusally Oral Gingival Epithelium Part of the epithelial lining of the entire oral cavity Covers he vestibular and lingual/palatal surfaces of the marginal and alveolar gingiva and the Interdental gingival papillae HISTOLOGY OF GINGIVA Epithelium Stratified squamous type, smooth in free gingiva, stippled in attached gingiva With 3 types of gingival epithelium o Fully keratinized (15%) o Parakeratinized (75%) o Non-keratinized (10%) Lamina Propria Consist of dense connecive tissue not highly vascular Fibroblast are abundant, macrophages are present, with plasma cells and lymphocytes BLOOD AND NERVE SUPPLY Blood supply of the gingiva is derived from periosteal vessels in the periosteum of the alveolar process Vessels supplying the dentogingival junction are derived from the intraalveolar arteries Innervated by terminal branches of periodontal nerve fibers and by the branches of the infraorbital and palatine or lingual, mental and buccal nerves

GINGIVA Part of the firm oral masticatory mucosa Surrounds the necks of the teeth Covers the alveolar processes of the jaws Color is normally pink or coral pink sometimes with grayish tinge Maybe pigmented brown or black due to melanin produced by the melanocytes CLINICAL PARTS OF THE GINGIVA Free Gingiva o Part which is freely movable o Not attached to the underlying structures Attached Gingiva o Part attached to the teeth and bone Free Gingiva Marginal Gingiva Part that tapers to a knife-like edge Extends along the cervical level of the tooth on the labial, buccal or lingual surface Interdental Papilla Part that fills the space between the teeth Pyramidal or triangular in shape with base directed towards the crest of the alveolar bone and apex towards the contact point In the posteriors, it is tent-shaped where the center part is like a valley called as Col

Anterior tooth Posterior tooth (col) Attached Gingiva Possesses tiny pinpoint stipplings With slight depressions in between the roots of the teeth called Interdental Folds FREE GINGIVAL GROOVE A slight indentation separating the free gingiva from the attached gingiva GINGIVAL SULCUS Gingival crevice A shallow groove between the free gingiva and the tooth extending around the circumference of the teeth The depth varies from 0-6mm Average depth is 1.8mm (normal) Probe - used to check the depth Where calcular deposits are located

The enamel space is created by loss (decalcification) of the enamel.