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3. Introduction
• Tongue is a complex muscular organ that is
anchored to hyoid bone, styloid process,
and genial tubercles of the mandible at the
insertion of 3 extrinsic tongue muscles.
Tongue is divided into
– Anterior part/Oral portion
– Posterior part/Base of the tongue
– Superior part/Dorsum of the tongue
– Under surface/Ventral surfaces
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4. Functions of the tongue
• Ingestion
• Suckling
• Swallowing
• Perception of taste
• Phonation
• Respiration
• Jaw development
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5. Development of tongue
• At about 4 weeks as the pharyngeal
arches meet in the midline beneath
the primitive mouth, local
proliferation of the mesenchyme, then
gives rise to a number of swellings in
the floor of mouth. First swelling
arises in the midline in the
mandibular process and is flanked by
2 other bulges called lateral
swellings. Very quickly these lateral
swellings enlarge and merge with
each other to form a large mass. From
which the mucous membrane of the
anterior two thirds of the tongue is
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7. • Hyphobronchial eminence – gives rise to the
mucosa covering, the root of the tongue and
epiglotis.
• Muscles of tongue
• Development of papila – lingual epithelium shows
specialization at about 7 weeks when the CV
papilla and foliate papilla first appear.
• Epithelium of tongue – develops from Ectoderm
(Anterior two third)
• Endoderm (Posterior one third)
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8. They start and wholly end
with in the tongue.
They include:
Superior longitudinal
Inferior Longitudinal
Transverse group
Vertical group
Intrinsic Group:
Tongue Musculature
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9. Extrinsic Group :
Are the group of
muscles that
originate outside
and run into it :
They include:
Hyoglossus
Styloglossus
Palatoglossus
Genioglossus
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10. Papillae
• Tongue is covered with stratified squamous
epithelium, scattered throughout this
epithelium. On the uppermost surface are 4
types of elevated structures known as
papillae.
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12. Fungiform papillae
• Present in the anterior
part of the tongue.
• Scattered among the
numerious filliform
papillae at the tip of
the tongue.
• Taste buds are present
in the epithelium on
the superior surface.
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13. Filliform papillae
• Cover the entire
anterior part of the
tongue bye keratinzed
epithelium.
• They form a tough
abrasive surface
involved in
compressing and
breaking food when
the tongue is opposed
to the hard palate.
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14. Foliate papillae
• Pressent on the lateral
margins of the
posterior part of the
tongue.
• Few taste buds are
present in the
epithelium of the
lateral walls of the
ridges.
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15. Circumvallate papillae
• Adjacent and anterior to
the sulcus terminalis
• 8 to 12 in number
• Surrounded by a deep
circular group into which
open the ducts of minor
salivary glands.
• Epithelium covering the
lateral walls is non
keratinised and contains
taste buds.
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16. Lingual Tonsils
• Situated near the mid line on the dorsum of
the tongue just behind the vallate papillae.
• Is a lymphoid tissue similar to the paletine
tonsil.
• Infection in this part of tongue will involve
the tonsils. Therefore it is an important
indicator of tonsillar infections.
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17. • Defined as a
specialized receptor
that occurs in the oral
cavity, pharynx and
within the epithelium
soft palate.
• Most of them are
found in fungi form,
foliate and CV papilla
of the tongue.
Taste buds
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18. Histology
• Taste bud is a barrel shaped structure
composed of 30-80 spindle shaped cells.
These cells are separated from the
underlying CT by the basement membrane.
Type 1 & 2 – sustentacular cells
Type 3 – gustatory receptor cells
• Outer surface if covered by flat epithelial
cells, which surrounds a small opening.
• Outer supporting cells are arranged like the
staves of a barrel.
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19. • Sweet (at the tip) - fungi
form papillae
• Salt (antero lateral border)
– fungi form papillae
• Bitter (posterior part in the
middle) – CV papillae
• Sour (posterior part in the
lateral areas) – Folliate
papillae.
• Special type of receptor
whose function is to detect
the taste of water has been
identified in the region of
CV papillae.
Primary taste sensation
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21. Blood supply
• Anterior two thirds – deep lingual artery
• Posterior one third – dorsal lingual artery to
the base of the tongue.
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22. • Motor nerve: All the intrinsic and extrinsic
muscles of the tongue except palatoglossus by 12th
cranial nerve. Palatoglossus is supplied bycranial
part of the accessory through the pharyngeal
complex.
• General sensation - Lingual nerve.
• Taste sensation - Chorda tympani for the anterior
two thirds of the tongue.
• Glossopharyngeal for the posterior one third and
also for the general sensation.
• Posterior most part is supplied by the vagus
through the internal laryngeal nerve
Nerve supply
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23. Clinical examination of tongue
• Nutritional deficiencies
• Pernious anemia
• Vitamin B complex
deficiency
• Diabetes mellitus
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24. • Impairment of local
immune mechanisms
where the langerhan’s
cells is decreased.
• Impairment of local
blood supply
• Diabetes mellitus
• Fungal infections
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25. • Tongue in tertiary
syphillis is affected by
gumma formation or a
more diffuse chronic
granulomatous lesion
– interstitial glossitis.
• Tongue exhibits non
ulcerating irregular
indurations with an
asymmetric pattern of
groves covering the
entire dorsun.
• Interstitial glossitis
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26. • Rounded or roughly
lozenge shaped, raised
aera that occurs in the
midline of the tongue
dorsum.
• Anterior to the vallate
papilla, affected area
is devoid of filliform
papillae.
• Median rhomboid glossitis
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27. • Lesion of unknown
etiology. It may be related
to emotional stress.
• Desquamation of the
filliform papillae in an
irregular circinate pattern.
• Margins of the lesion are
hyperkeratotic and
acanthotic in some areas.
• Treatment is empirical.
• Geographic tongue
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28. • Characterized by
hypertrophy of the
filliform papillae with
lack of normal
desquamation.
• Fungal infections may
incite this condition.
• Oral use of certain
drugs like pencilin,
aureomycin may incite
this condition.
• Hairy tongue
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29. • Clinically manifested
by numerous small
furrows or groves
often radiating from a
central groove along
the midline on the
dorsal surface.
• Develop
simultaneously as a
sequel to geographic
tongue.
• Fissured tongue
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30. Palpation
• Ask the patient to protrude the tongue on to
gauze
• Aided bye the gauze dentist can hold the
tongue while using the mirror to observe
• Palpation of the tongue should be done both
left to right and vice versa
• The targeted areas are the lateral borders
and the region of valate papillae
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31. Abnormalities of taste
• Ageusia
Complete
Partial
• Hypogeusia
• Dysgeusia
• Cacogeusia
• Torquegeusia
• Gustatory agnosia – loss of ability to classify
contrast or identify a given taste stimulus
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33. Clinical importance
• Due to long term edentulousness tongue
will expand, introduction of a new denture
will be met with dislodging competition
from the tongue.
• Repeated guiding and tongue exercise will
help in altering the size to some extent, over
a period of time tongue will adapt to the
new environment.
• Surgical trimming has been used to reduce
the bulk of tissue present in severe cases.
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34. Ankyloglossia
• Tongue type is defined on
the basis of in ability to
extend the tip of the tongue
beyond the vermillion
border of the lip.
• Syndromes
orofacial digital syndrome
trisomy 13
vanderwoode’s
glasoopalatine ankylosis
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35. Clinical importance
• Severe degree of ankylosis of an exhibit
midline mandibular diastema and lingual
mandibular periodontal defects.
• Difficulty in making the impression which
hampers the retention of denture.
• Altered speech
• Correction
• Mild – speech therapy
• Severe – clipping of frenum
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36. Position of tongue
• Tongue position is important to the prognosis of the
mandibular denture.
• Classification of tongue position :
• Class I
• Tongue lies in the floor of the mouth with the tip forward and
slightly below the incisal edges of the mandibular teeth.
• Class II
• Tongue is flattened and broadened but the tip is in the normal
position.
• Class III
• Tongue is retracted and depressed in to the floor of the mouth
with the tip curled upward,downward or assimilated in to the
body of the tongue.
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37. Role of the tongue in speech
• Speech adaptation to new complete dentures
normally takes 2 to 4 weeks after insertion.
• Sounds like this,that,these are made with the tip of
the tongue extending slightly between the upper
and lower teeth.
• This will provide for labio lingual positioning of
the anterior teeth.
• If about 3 mm of tip is not visible, the anterior
teeth are probably too forward in placement.
• Also if the vertical overlap is excess that does not
allow sufficient space for the tongue to protrude
between the anterior teeth.
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38. • Linguo alveolar sounds: t,d,s,z,v&l
While pronouncing these sounds the tip of the
tongue contacts with the most anterior part of the
palate or lingual aspect of the anterior tooth.
• Sibilant sounds:
Alveolus and tongue form the controlling valve.
S- It’s articulation is mainly influenced by the teeth
and palatal part of the maxillary prosthesis.
The tongue’s anterior dorsum forms a narrow groove
near the mid line with a cross section of about 10
mm.The size and shape of the space will determine
the quality of the sound.
If the opening is too small- a whistle is heard.
If the space is too broad- a lisp is heard.
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39. Bibliography
• Human embryology – I.B.singh 7th Edition
• Human Anatomy – B.D.Chaurasia Vol 3
• Oral Histology – A.R.Tencate 10th
Edition
• Oral Histology – Orban 5th
Edition
• Human Physiology – Guyton 8th
Edition
• Treatment for edentulous patients– Carl O
Boucher 10th
Edition
• Text Book on Complete Dentures – John
Joseph Sharry
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