The document discusses the anatomy and function of the major and minor salivary glands. It describes the location and secretory products of the parotid, submandibular, and sublingual glands. It also covers the clinical considerations of various salivary gland disorders like xerostomia, salivary gland infections, Sjogren's syndrome, and tumors. For prosthodontists, understanding salivary gland anatomy is important to avoid obstruction of the parotid and submandibular ducts during denture construction.

1. DEPARTMENT OF PROSTHODONTICS
PRESENTED BY
DR C PRADEEP
PG STUDENT

2. Contents
 Introduction
 classification
 Development of Salivary Glands
 Anatomy
 Parotid gland
 Submandibular gland
 Sublingual gland
 Minor salivary gland
 CLINICAL CONSIDERATION
 PROSTHODONTIC IMPLICATIONS
 References

3. Introduction
Salivary glands are compound, tubuloacinar exocrine
glands whose ducts open into the oral cavity. They
secrete saliva, a fluid which
 Lubricates food to assist deglutition,
 Moistens the buccal mucosa, which is important for
speech, and
 Provides an aqueous solvent necessary for taste.
 Contains digestive enzymes, e.g. salivary
amylase
 Antimicrobial agents e.g. IgA, lysozyme etc

4. .Based on size
Based on type
of secretory cells

5.  1. Major salivary glands
 2. Minor salivary glands
 1. Major salivary glands
 Collection of secretory cells aggregated into large
bilaterally paired extra oral glands with extended duct
system through which the gland secretions reach the
mouth.
 - Parotid
 - Submandibular
 - Sublingual

6. Collection of secretory cells scattered
throughout the mucosa & submucosa of the
oral cavity with short ducts opening directly
onto mucosal surface.
- Serous glands of Von Ebner.
- Anterior lingual glands.
- Lingual, buccal, labial, palatal
glands, glossopalatine and retromolar
glands

7.  1. Serous : Parotid
 2. Mixed (seromucous): Submandibular
 3. Mucous: Minor salivary glands.

8. Development of Salivary Gland
 During the fetal life each salivary gland is formed at
specific location in the oral cavity
 The submandibular and sublingual develop in the
floor of the stomodeum.

9.  Individual salivary glands
arise as a proliferation of
oral epithelial cells,
forming a focal thickening
that grows into underlying
ectomesenchyme.
 Continued growth results
in formation of a small bud
connected to the surface by
a trailing cord condensing
around the bud.

10. Lumen formation may involve apoptosis of
centrally located cells in the cell cord.
Following development of lumen in terminal
buds, the epithelium consists of two layers of
cells.
Inner layer Cells of inner layer differentiate
into secretory cells of mature glands.
Outer layer (Some cells) form the contractile
myoepithelial cells that are present around the
secretory end pieces & intercalated duct.

11. Connective tissue
Salivary gland has connective tissue component
that diminishes as parenchyma expands;
Even so every terminal end piece
and every duct
remain supported by
tenuous connective tissue
component carrying
blood vessels and nerves.
(The presence of functional
innervations is also
essential to proper growth & maintenance of
salivary glands structure.)

12.  Post natal growth
The glands continue to grow postnatally with the
volume proportion of acinar tissue increasing
up to2 yr of age.
The volume proportion of ducts, connective
tissue and vascular elements decreasing up to
2 yr of age.

14. Ductal system of a salivary
gland:
Main excretory duct opens into the
oral cavity. Excretory ducts are
mostly located in the interlobular
connective tissue.
Striated ducts are the main
intralobular ductal component.
Intercalated ducts vary in length
and connect the secretory end
pieces with the striated ducts.
Intercellular canaliculi are
extensions of the lumen of the end
piece between adjacent secretory
cells that serve to increase the
luminal surface area available for
secretion.

16. The paired parotid glands
are the largest of the
salivary glands.
The gland is an irregular,
lobulated, yellowish mass,
lying largely below the
external acoustic meatus
between the mandible
and sternocleidomastoid
muscle.

17. The gland also projects
forwards on the surface
of masseter.
In 20% of cases, a small,
usually detached, part
called the accessory
parotid gland lies
between the zygomatic
arch above and the
parotid duct below.

18. From medial to the lateral
side these are:
Arteries:
External carotid artery
Maxillary artery
Superficial temporal vessel
Posterior auricular artery
Veins:
Retromandibular vein
Facial nerve

19. Maxillary artery leaves
the gland through its
anteromedial surface.
Superficial temporal
vessel: emerge at the
anterior part of the
superior surface
Posterior auricular artery
may arise within the
gland.

20. Veins :
The Retromandibular
vein is formed within
the gland by the union
of superficial temporal
and maxillary veins.

21. Nerves:
Facial nerve enters the
gland through the upper
part of its
posteromedial surface.
The nerve divides into
its terminal branches
within the gland.

22. Parotid duct
The parotid duct begins by the confluence of
two main tributaries within the anterior part of
the gland.
It appears at the anterior border of the upper
part of the gland and passes horizontally
across masseter,
approximately at the level midway between the
angle of the mouth and the zygomatic arch.

23.  While crossing masseter it can receive the
accessory parotid duct and lies between the
upper and lower buccal branches of the facial
nerve.
 The duct is 5 cm long and its lumen is 3
mm wide.

24.  The arterial supply to the parotid gland is
from the external carotid artery and its
branches within and near the gland.
 The veins drain to the external jugular vein
via local tributaries.

25.  Lymph nodes are found both in the skin
overlying the parotid gland (preauricular
nodes) and in the substance of the parotid
gland itself.
 There are usually 10 lymph nodes present
in the gland.
 The majority are found in the superficial
part of the gland lying above the plane
related to the facial nerve.

26.  The deeper part of the parotid gland
beneath the branches of the facial nerve
contains one or two lymph nodes.
 Lymph from the parotid gland drains to the
upper deep cervical lymph nodes.

27.  Parasympathetic nerves(secretomotor)
 Inferior salivatory nucleus
 Glossophyrengal nerve.(tympanic branch)
 Tympanic plexus
 Lesser petrosal nerve
 Otic ganglion
 Auriculotemporal nerve
 Parotid gland

28.  Sympathetic nerve supply:
 Vasomotor -Derived from the plexus
around the external carotid artery
 Sensory nerve supply:
 Auriculotemporal nerve

29.  Because of fibrous fascia is covering the
parotid, its inflammatory swelling is tense
and hard.
 Parotid duct is slightly larger along their
course than at their caruncle.
 This permits storage of secretions so that a
ready flow may be available on stimulation
without waiting for secretory process.

30.  The submandibular gland is irregular in
shape and about the size of a walnut.
 It consists of a larger superficial and a
smaller deep part, continuous with each other
around the posterior border of mylohyoid.
 It is a seromucous (but predominantly
serous) gland.

31. 2nd largest salivary gland
• Shape & size – roughly J
shaped & about the size of a
walnut
• Weight – 8 to 10gm each
• Location – posterior part of
the floor of the mouth,
tucked up against the
medial aspect of the body of
mandible
• Secretory duct – Wharton’s
duct -

32. The arteries supplying the gland are branches
of the facial and lingual arteries.
The lymph vessels drain into the deep
cervical group of lymph nodes (particularly the
jugulo-omohyoid node),
interrupted by the submandibular nodes.

34. Also known as Wharton's duct.
The submandibular duct is 5 cm long and has a
thinner wall than the parotid duct.
It begins from numerous tributaries in the
superficial part of the gland and emerges from the
medial surface of this part of the gland behind the
posterior border of mylohyoid.
It traverses the deep part of the gland, passes at
first up and slightly back for 5 mm, and then
forwards between mylohyoid and hyoglossus.

35.  It next passes between the sublingual gland and
 genioglossus to open in the floor of the mouth
on the summit of the sublingual papilla at the
side of the frenulum of the tongue.
 It lies between the lingual and hypoglossal
nerves on hyoglossus, but, at the anterior border
of the muscle, it is crossed laterally by the lingual
nerve, terminal branches of which ascend on its
medial side.
 As the duct traverses the deep part of the gland
it receives small tributaries draining this part of
the gland.

36.  The secretomotor supply
 Superior salivatory nucleus
 Facial nerve
 Chorda tympani
 Submandibular ganglion
 Postganglionic parasympathetic fiber
supplying gland.

37. Sensory nerve supply:
Lingual nerve
Vasomotor nerve supply:
Plexus around the facial artery

38.  The arteries supplying the gland are
branches of the facial and lingual arteries.
 The veins drain into the common facial or
lingual vein.
 The lymph vessels drain into the deep
cervical group of lymph nodes (particularly
the jugulo-omohyoid node), interrupted by
the submandibular nodes.

39.  The entire submandibular gland and duct system
lies in a dependent position, which predisposes it
to retrograde invasion by oral flora.
 Similar to the parotid duct, the Wharton’s duct
is also wider before reaching the papilla. This can
lead to stangulation of saliva and the organic
matter.
 The sharp bends of Wharton’s duct at the
posterior border of the mylohyoid muscle allows
stasis of the saliva favoring the formation of
salivary stones.

40.  The sublingual gland is the smallest of the
main salivary glands: each gland is narrow,
flat, shaped like an almond, and weighs 4 g.
 The sublingual gland lies on mylohyoid, and
is covered by the mucosa of the floor of the
mouth, which is raised as a sublingual fold.
 The anterior end of the contralateral
sublingual gland lies in front, and the deep
part of the submandibular gland lies behind.

41.  The mandible above the anterior part of the
mylohyoid line, the sublingual fossa, is
lateral, and genioglossus is medial, separated
from the gland by the lingual nerve and
submandibular duct.
 The sublingual glands are seromucous, but
 predominantly mucous.

42.  The arterial supply is from the sublingual
branch of the lingual artery and the
submental branch of the facial artery.
 Lymphatic drainage is to the submental
nodes.

43. The sublingual gland has 8-20 excretory ducts. Smaller
sublingual ducts open, usually separately, from the
posterior part of the gland onto the summit of the
sublingual fold (a few sometimes open into the
submandibular duct).
Small rami from the anterior part of the gland
sometimes form a major sublingual duct (Bartholin's
duct), which opens with, or near to, the orifice of the
submandibular duct.
This duct may be visualized occasionally in a
submandibular sialogram.

44. Minor salivary glands are found throughout the oral cavity,
except in the anterior part of the hard palate & the gingiva.
The minor salivary glands of the mouth include:
Labial ,
Buccal ,
Palatoglossal ,
Palatal
Lingual glands.
The labial and buccal glands contain both mucous and
serous elements.
The palatoglossal glands are mucous glands and are located
around the pharyngeal isthmus.

45. LABIAL / BUCCAL GLANDS
• Gland on lips and cheeks.
• Mixed type
GLOSSOPALATINE GLANDS
• Principally localized in the
region of isthmus in glossopalatine fold.
• Pure mucous gland

46.  The palatal glands are mucous glands and
occur in both the soft and hard palates.
 The anterior and posterior lingual glands
are mainly mucous.
 The anterior glands are embedded within
muscle near the ventral surface of the tongue
and open by means of four or five ducts near
the lingual frenum and the posterior glands
are located in the root of the tongue.

47.  The sublingual gland and the minor salivary
glands have short ducts, where the chances
of stasis are less.
 Thus, obstructive lesions do not occur in
the glands.
 Since minor salivary glands are placed
superficially, the traumatic lesions such as
Mucoceles commonly affect these glands.

48.  Xerostomia:
 Drugs- central or peripheral inhibition of salivary
 secretion.
 Destruction of salivary gland:
 -Radiotherapy
 -Chemotherapy
 -Bone marrow transplant
 -Autoimmune diseases (sjogren’s syndrome)-
 invasion of lymphocytes & destruction of epithelial
cells.
 Psychological factors
 Malnutrition

49.  Refers to excess saliva production.
 Causes:
 -Gastrointestinal irritants
 -Drugs (Pilocarpine)
 -Cerebro vascular accident
 -Pt. with a severe neurologic deficit
 -Pt. who have undergone extensive oral
 surgical procedures.

50.  1.Sialolith (stones)
 Mostly in submandibular gland
 2.Mucous plugging in minor salivary glands
due to trauma.
 Age changes:
 Parenchymal cells are replaced by adipose
tissue.
 Decreased saliva production
 Resting saliva(unstimulated) is in normal
range, while stimulated
 saliva is less.

51. Viral( mumps) & bacterial infections-
painful swelling .

52.  Diabetes :
 Parotid gland swelling may occur
 Salivary flow is reduced.
 Changes in salivary proteins.
 Autoimmune diseases may cause destruction of
salivary glands &
 reduced salivary flow.
 Sjogren’syndrome
 Rheumatoid arthritis
 Graft-verus host diseases
 Patients with adrenal disease may have altered electrolyte
composition.

53.  Decreased flow rates.
 Lower levels of immunoglobulins in saliva
 Parotid enlargement – lympathedenopathy
and lymphoepithelial cysts
 Genetic diseases:
 Cystic fibrosis: Na+ & Cl- conc. are
increased and mucous secreting
 glands may develop mucous plugs.
 Benign & malignant tumours.

54.  • From the prosthodontists point of view, salivary
glands are of great importance both anatomically
and physiologically.
 Extension of denture base:
 Stenson's duct - it is rare for a maxillary denture
to cause obstruction to this duct.
 • Wharton’s duct - extension of the lingual
flange in this region can lead to obstruction –
patient complains of swelling under the tongue
while eating.
 Sublingual - it is rare for a denture to cause any
significant obstruction

55. In complete denture
• Procedures -aim at optimizing retention and stability.
• Use dentures with metal bases.
• Use of soft liners to improve comfort.
• Use of denture adhesives to augment retention.
• Frequent recall – As more prone to candida infections.
• Fabrication of intra oral artificial salivary reservoirs.

56.  Excessive salivation due to sub mandibular
and sublingual gland causes difficulty in
impression making of complete dentures.
 Administration of drugs should be done
before making impression.
 Excessive secretion from the mucous glands
in the palate region causes distortion of the
impression material.
 To counteract this problem, the palate may
be massaged to encourage the glands to
empty, the mouth may be irrigated with
astringent and the palate may wiped with
gauze

57. Palatal wax removed2-mm thick modeling
wax
Prosthodontic Management of
Xerostomic Patient:
A Technical Modification
Complete denture with salivary
reservoir

58. Putty adapted over the central
area to form the reservoir
Lid and the denture cured separately
Lid permanently
Attached
with autopolymerizing
acrylic resin
Inlet and outlet
holes

59.  Artificial saliva substitute (wet mouth, ICPA
Health Products Ltd., MUMBAI, INDIA) was
then used for filling the reservoir space

60.  Various postinsertion instructions provided to the
patient are:
 Guidelines were given to the patient with respect to oral care
and denture maintenance
 Instructions were given to the patient regarding the cleaning
of the reservoir space. The patient was schooled to clean the
reservoir daily with a small brush and a fine orthodontic wire
 The patient was advised to flush out the reservoir with 1%
sodium hypochlorite solution once a week
 The patient was told to fill the reservoirs 3–4 times a day with
artificial saliva
 It was advised to drink at least eight glasses of water, lemon
juice, or milk

61. In Removable partial denture
• Anti sialagogues administered 1to 2 days
before treatment.
• Impression making: mouth irrigated with an
astringent.
• Mouth washed prior to investing impression
material.
• Fast setting impression material is used.
• Patient’s mouth should be packed with 4x4
inch gauze that has been folded to form an
absorptive strip.
• “ Tandem” impression technique.

62. • • Failure to remove saliva from the
impression will result in an inaccurate cast
• Thin, serous saliva to be washed under cool
tap water. If running tap water is not effective,
the saliva can be removed using a soft camel
hair brush and a mild detergent.
• Thick, ropy saliva- a thin layer of dental
stone be sprinkled the surface of the
impression

63.  When an impression is made or a restoration
is cemented,
 great degree of dryness is required
 • Achieved by using-
 • Rubber dam, high-volume vacuum, saliva
ejector, antisialagogues.
 Methantheline bromide (banthine) and
 propantheline bromide (pro-banthine).

64. The components of saliva act as a mirror of the body’s
health.
• The multi factorial role of salivary components
continue to represent a focused area of dental
research.
• The knowledge of normal salivary composition, flow
& function is extremely important on a daily basis when
treating patients.
• Dental health professionals spend untold hours
removing this precious natural resource to perform
therapy, with little regard to its value until flow is
significantly reduced.
• Whether saliva occurs in quantities large or small ,
recognition should be given to the many contributions
it makes to the preservation & maintenance of oral &
systemic health.

65.  References
 Ten Cate’s Oral histology Development, Structure nd
Function Sixth Edition
 General Anatomy 3rd vol. by B. D. Chaurasia
 Maxillary reservoir denture to overcome radiation-induced
xerostomia – Light at the end of the tunnelSudhanshu
Srivastava1, Preety Negi2, Devendra Chopra1, Sumit Misra
 Prosthodontic Management of Xerostomic Patient:
 A Technical Modification
 Haraswarupa Gurkar, Omprakash Yadahally Venkatesh,
JagadeeshMandya Somashekar,
 Muthuraj Hariharapura Lakshme Gowda, Madhavi Dwivedi,
and Ishani Ningthoujam
 Edgerton M, Tabak LA, Levine MJ. Saliva: A significant factor
in removable prosthodontic treatment. J Prosthet Dent. 1987;
57(1):
 57-66.