anatomy and clinical consideration of palate are discussed

1. Made by – Zareesh.s.Akhtar
1 year mds
Department of oral medicine and radiology

2. Content
• Introduction
• Hard Palate
• Osteology
• Soft Palate
• Muscles Of Soft Palate
• Blood Supply
• Nerve Supply
• Development Of palate
• Clinical Consideration

3. Introduction
• Palate – Roof of the oral cavity
• It has two parts
1- An anterior hard palate
2- A posterior soft palate

4. Hard Palate
• Separates the oral cavity from the nasal
cavities
• Consists of a bony plate covered above and
below by mucosa
• Above- covered by respiratory mucosa and
forms floor of nasal cavity (superior surface)
• Below- covered by oral mucosa and forms
much of the roof of oral cavity(inferior
surface)

5. Formed by
• Palatine processes of maxillae in front
• Horizontal plates of palatine bones behind
• Bounded by alveolar arches
• Posteriorly continues with soft palate
• Its under surface covered by mucoperiosteum
• Show transverse ridges in the anterior parts

6. Position
• The anterolateral margins of the palate are
continuous with the alveolar arch and gums
• The posterior margins gives attachment to
the soft palate
• The superior surface forms the floor of the
nose
• The inferior surface forms the roof of the
oral cavity

7. Osteology
• Palatine processes of the maxillae form anterior ¾ of the
hard palate
• Horizontal plate of the palatine bones form the posterior ¼
of the hard palate

8. • Suture
• Intermaxillary Suture
• Interpalatine Suture
• Palatomaxillary Suture
• Incisive Canal
Content – Greater palatine vessel
Nasopalatine
nerve[terminal part]

9. • Greater palatine foramen
Content – Greater Palatine vessels
Anterior Palatine nerve
• Lesser Palatine Foramen
Content – Middle and Posterior
palatine nerves

10. Soft palate
 Movable ,muscular fold ,suspended from the
posterior border of the hard palate
 It separates the nasopharynx from the
oropharynx
 Acts as a valve that can be
1.-depressed to help close the oropharyngeal
isthmus.
2.-elevates to separate the nasopharynx from the
oropharynx.

11. • Has two surfaces
• 1 Anterior (oral) surface; is concave and is marked by median
raphe.
• 2 Posterior surface is convex and is continuous superiorly with
the floor of the nasal cavity

12. • Has two borders
• 1 superior border is attached to the posterior border of the hard
palate ,blending on each side border of the hard palate ,with the
pharynx.
• 2 .Inferior border is free and bounds the pharyngeal isthmus.
• From its middle there hangs a conical projection,called uvula .

13. • Has two folds
• From each side of the ovulae ,two curved folds of mucous
membrane extend laterally and downwards
• The anterior fold is called as palatopharyngeus arch (ant pillar
of faucets) it contains palatoglossuss muscle and reaches the
side of the tongue at the junction of its oral and pharyngeal
parts.
• The posterior fold is called the palatopharyngeal arch (post
pillar of fauces) contains palatopharyngeus muscle .
• And it forms the posterior boundary of the tonsillar fossa,
and merges inferiorly with lateral wall of the pharynx.

14. Muscle of palate
• Tensor veli palatini
• Levator veli palatini
• Musculus uvulae
• Palato pharyngeus
• Palato glossus

15. TENSOR VELI PALATINI
Origin
 Lateral side of auditory tube
 Scaphoid fossa of sphenoid bone
Insertion
 Palatine aponeurosis
Nerve Supply
 Mandibular nerve branch to medial
pterygoid muscle
Action
 Tightens the soft palate
 Open the auditory tube

16. LEVATOR VELI PALATINI
Origin
 Petrous temporal bone
 Inferior aspect of auditory tube
Insertion
 Upper surface of palatine aponeurosis
Nerve Supply
 Vagus nerve via pharyengeal plexus
Action
 Elevated the soft palate

17. MUSCULUS UVULAE
Origin
 Posterior nasal spine of hard palate
Insertion
 Connection of uvula
Nerve Supply
 Vagus nerve via pharyngeal plexus
Action
 Elevates and reacts uvula
 Thickens central region of soft palate

18. PALATOGLOSSUS
Origin
 Inferior surface of palatine aponeurosis
Insertion
 Lateral margin of tongue
Nerve Supply
 Vagus nerve via pharyngeal plexus
Action
 Depress palate
 Moves palatoglossal arch toward midline
 Elevates back of the tongue

19. PALATOPHARYNGEUS
Origin
 Superior surface of palatine aponeurosis
Insertion
 Pharyngeal wall
Nerve supply
 Vagus nerve via pharyngeal plexus
Action
 Depresses soft palate
 Moves palatopharyngeal arch toward midline
 Elevates pharynx

20. Pterygoid hamulus
Pharyngotympanic tube
Palatoglossus muscle
Palatopharyngeus muscle
Tensor veli palatini
Levator veli palatini

21. Buccinator muscle
Pterygomandibular raphe
Palatine tonsil
Platatoglossus muscle
Palatopharyngeal
muscle
Superior constrictor
Uvula
muscle
Palatine aponeurosis

22. PASSAVNT’S RIDGE
• Some of the upper fibres of the palatopharyngeal passes circularly deep
to mucous membrane of the pharynx
• Forms a sphincter internal to the superior constrictor
• This constitute the Passavant’s muscle
• On contraction raises a ridge called Passavant’s ridge
• Best developed in the cleft palate cases

23. Movement and function
• Plays important role in
• Swallowing
• Chewing
• Voice
• Sneezing
• Coughing
• Act as a traffic controller between oropharynx and
nasopharynx

24. BLOOD SUPPLY

25. VEINS
• Pterygoid plexuses
• Tonsillar plexuses of vein

26. LYMPHATICS
• Upper deep cervical
• Retropharyngeal lymph nodes

27. NERVE SUPPLY
• Supplied by the greater and lesser palatine nerve
and the nasopalatine nerve

28. • General sensory fibres carried in all these
nerves originate in the pterygopalatine fossa
from the maxillary nerve

29. • Special sensory and secretomotor nerves are contained in
lesser palatine nerves

30. DEVELOPMENT OF PALATE
• Develops as two part
• The primary palate
• The secondary palate

31. Development Of The Primary Palate
Fusion of the two medial nasal processes with
frontonasal process result in the formation of primary
palate

32. Development Of The Secondary Palate
• The formation of secondary palate commence between 7 and 8
week and complete around the 3rd month of the gestation
• Three outgrowth appear in the oral cavity
-The two palatal process
-The nasal septum

33. • Each palatal process grow downward
first then upward after the withdrawal of
tongue (7th week)
• Septum and the two shelves converge
and fuse in the midline
• The closure of the secondary palate
proceed gradually form the primary
palate in a posterior direction.

34. CLINICAL
CONSIDERATION

35. Classification of soft palate by M M House
• Class1 –Soft tissue is almost horizontal
• Class2 – Soft palate turns downward at an angle
of 450 from hard palate
• Class 3 – Soft palate turns downward sharply at
an angle of 75o from hard palate

36. Roughly correspondes to Cormack
and Lehane’s Laryngoscopy views
• Class I- visualization of the soft palate ,fauces
,uvula and both anterior and posterior pillars
• Class II –Visualization of the soft palate,
Fauces and uvula
• ClassIII –Visualization of the soft palate and
the base of uvula
• Class IV – Difficult visualization of soft palate

37. Uranoschisis -CLEFT PALATE
• Congenital birth defect
• Defective fusion of the maxillary process / Palatal
process of palate gives rise to cleft in palate
• Etiology
 Defective growth of palatal shelves
 Lack of contact between shelves
 Post fusion rupture of shelves
 Delayed /failure of shelves to attain a horizontal
position

38. Classification of cleft palate
• Veaus Classification
• Class 1 incomplete cleft involving only
soft palate
• Class2 cleft involving hard and soft
palate
• Class3 complete unilateral cleft
involving lip and palate
• Class4 complete bilateral cleft

40. Dental problems
• Congenital missing teeth
mostly upper lateral incisors
• Presence of supernumerary,
neonatal and natal teeth
• Ectopically erupted tooth
• Enamel hypoplasia
• Microdontia ,macrodontia
• Fused teeth
• Gemination ,dilaceration
• Tendency toward class III
skeletal pattern
• Posterior and anterior cross bite
• Deep Bite
• Spacing / Crowding
• Protruding premaxilla

41. TORUS PALATINUS
• Localised nodular enlargement of the
cortical bone
• Usually midline of the palate
• Pose a mechanical problem in the
construction of denture

42. INFLAMMATORY PAPILLARY
HYPERPLASIA
• Common lesion that develops on the central hard palate in response to
chronic denture irritation

43. SMOKER’S PALATE
• Also known as nicotine stomatitis
• An erythematous irritation is
initially seen ,followed by a whitish
palatal mucosa reflecting a
hyperkeratosis
• Red dots representing orifices of
accessory salivary glands seen

44. HIGH ARCHED PALATE
• Developmental feature that may occur in
isolation or in association with a number of
conditions
• Acquired condition caused by chronic thumb
sucking
• High arched palate may cause narrowed
airway and sleep disordered breathing
• Pose difficulty in the construction of denture
Normal arch palate
High arch palate

45. Incisive canal cysts
• Incisive canal cysts, also known as nasopalatine duct
cysts (NPDC), are developmental, non-neoplastic cysts arising from
degeneration of nasopalatine ducts.
• These ducts usually regress in fetal life. The persistence of ductal
epithelium leads to formation of cyst.
• It is considered the most common non-odontogenic cyst and develops
only in the midline anterior maxilla.
• It represents as asymptomatic palatal swelling

46. • They are seen as a solitary well-
defined, oval or round unilocular
radiolucency, between central
incisors, >0.6 cm in diameter. They
may appear “heart-shaped” if the
anterior nasal spine superimposed.
Root resorption and tooth
displacement may be present.

47. Paralysis of soft palate
• The pharyngeal isthmus can not be closed during swallowing and
speech
• Nasal regurgitation
• Nasal Twang
• Flattening of palatoglossal arch

48. Staphyloschisis –cleft of soft palate

49. Reference
• B D Chaurasia’s human anatomy
• Burkets oral medicine
• Human embryology –Inderbir singh
• Text book of oral and maxillofacial surgery by Nillima malik
• Hard and soft palate Springer International Publishing Switzerland 2017 199
T. von Arx, S. Lozanoff, Clinical Oral Anatomy, DOI 10.1007/978-3-319-
41993-0_10
• The Palate - Hard Palate - Soft Palate - Uvula – TeachMeAnatomy Original
Author(s): Krishan Kulkarni Last updated: November 20, 2020 Revisions: 10
• Palate Website Encyclopaedia Britannica, Inc.December 17, 2020