Normal Cells and Tissues

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oral and maxillofacial pathology

Epithelial cells Layers of epithelium Skin and oral mucous membrame Connective tissue Arteries Nevers Muscle Nucleus Sebaceous glands Hyaline cartilage Fibro cartilage Elastic cartilage Chondrocyte 2 main patterns: keratinisation and non keratinisation. Kertinisation: mucosal surface result from formation of a surface layer of keratin and process of maturation is called kertinisation Its tough, resistant to abrasion and tightly bound to lamina propria. Shows 4 layers: Stratum basele Stratum spinosam Stratum granulosam Stratum corneum Labial/Buccal mucosa > Thick non keratinised Alveolar mucosa > Thin non keratinised Ventral tongue > Thin non kertinised Soft palate > Thin non keratinised Masicatory mucosa- ( ortho/ para keratinised) Hard palate >Thick ortho keratinised Attached mucosa > Thick keratinised Ortho keratinised (or) Para keratinised

Normal
Cells and Tissues
Dr. Amitha G, BDS, MDS
Oral and Maxillofacial pathology

Content
 Epithelial cells
 Layers of epithelium
 Skin and oral mucous membrame
 Connective tissue
 Arteries
 Nevers
 Muscle
 Nucleus
 Sebaceous glands
 Hyaline cartilage
 Fibro cartilage
 Elastic cartilage
 Chondrocyte

skin

Types of Cartilage

Normal Cells and Tissues

Normal Cells and Tissues

Normal Cells and Tissues

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Definition General properties Composition Function of saliva Formation of saliva Method for collecting saliva Advantages Limitations Analysis of saliva done for the diagnosis of systemic disease Definition: by Stedmann’s & Lipincott medical dictionary. A clear, tasteless, odourless, slightly acidic (pH 6.8) viscous fluid, consisting of the secretion from the parotid, sublingual, submandibular salivary glands and the mucous glands of the oral cavity. General properties Volume: 1000 to 1500 mL of saliva is secreted per day and, it is approximately about 1 ml/ minute. Contribution by each major salivary gland is: i. Parotid glands: 25% ii. Submandibular glands: 70% iii. Sublingual glands: 5%. Reaction: Mixed saliva from all the glands is slightly acidic with pH of 6.35 to 6.85. Specific gravity: It ranges between 1.002 and 1.012. Tonicity: Saliva is hypotonSalivary flow The average person produces approximately 0.5 L – 1.5 L per day Unstimulated Flow (resting salivary flow―no external stimulus) Typically 0.2 mL – 0.3 mL per minute Stimulated Flow (response to a stimulus, usually taste, chewing, or medication [eg, at mealtime]) Typically 1.5 mL – 2 mL per minute

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INTRODUCTION Tongue is a muscular organ Situated in the floor of the mouth FUNCTION Taste Speech Mastication Deglutition EXTERNAL FEATURES Tongue has A Root A tip A body ROOT Is attached to the mandible and soft palate above and hyoid bone below. These attachments prevent the swallowing of the tongue. In between the 2 bones  it is related to the geniohyoid and mylohyoid muscles. TIP Of the tongue forms the anterior free end which lies behind the upper incisor teeth. BODY Has A curved upper surface or dorsum An inferior or ventral surface MUSCLES OF THE TONGUE Middle fibrous septum divides the tongue into right and left halves. Intrinsic muscles Superior longitudinal Inferior longitudinal Transverse Vertical Extrinsic muscles Genioglossus Hyoglossus Styloglossus Palatoglossus

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oral and maxillofacial pathology

Central face begins to develop by 4th week, when olfactory placodes appear on both sides of the frontonasal process. Gradually both placodes develop to form the median and lateral nasal process. Upper lip is formed by 6th week by fusion of two median nasal processes in midline and the maxilllary process of the 1st branchial arch. PRE-NATAL GROWTH AND DEVELOPMENT OF PALATEFormation of primary and secondary palate Elevation of palatal shelves Fusion of palatal shelves

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oral and maxillofacial pathology

Occipital (2-4) Superior nuchal line between sternocleidomastoid and trapezius Occipital part of scalp Superficial cervical lymph nodes Accessary lymph nodes Mastoid (1-3) Superficial to sternocleidomastoid insertion Posterior parietal scalp Skin of ear, posterior external acoustic meatus Superior deep cervical nodes Accessary lymph nodes Preauricular (2-3) Anterior to ear over parotid fascia Drains areas supplied by superficial temporal artery Anterior parietal scalp Anterior surface of ear Superior deep cervical lymph nodes Parotid (up to 10 or more) About parotid gland and under parotid fascia Deep to parotid gland External acoustic meatus Skin of frontal and temporal regions Eyelids, tympanic cavity Cheek, nose (posterior palate) Superior deep cervical lymph nodes Facial Superficial(up to 12) Maxillary Buccal Mandibular Distributed along course of facial artery and vein Skin and mucous membranes of eyelids, nose, cheek Submandibular nodes Deep Distributed along course of maxillary artery lateral to lateral pterygoid muscle Temporal and infratemporal fossa Nasal pharynx Superior deep cervical lymph nodesSuperficial Anterior jugular vein between superficial cervical fascia and infrahyoid fascia Skin, muscles, and viscera of infrahyoid region of neck Superior deep cervical lymph nodes Deep Between viscera of neck and investing layer of deep cervical fascia Adjoining parts of trachea, larynx, thyroid gland Superior deep cervical lymph nodes Anterior cervical/Superficial Submental (2-3) Submental triangle Chin Medial part of lower lip Lower incisor teeth and gingiva Tip of tongue Cheeks Submandibular lymph node to jugulo-omohyoid lymph node and superior deep cervical lymph nodes

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• Function • External features • Papillae of tongue • Muscles of the tongue • Arterial supply • Venous drainage • Lymphatic drainage • Nerve supply • Histology • Development of tongue - Intrinsic muscles  Superior longitudinal  Inferior longitudinal  Transverse  Vertical - Extrinsic muscles  Genioglossus  Hyoglossus  Styloglossus  Palatoglossus 1. Vallate or circumvallate papillae These are large in size 1-2mm in diameter and are 8-12 in number. They are situated immediately in front of the sulcus terminalis. Each papillae are cylindrical projection surrounded by a circular sulcus. The walls of the papilla are raised above the surface. 2. Fungiform papillae Are numerous Near the tip and margins of the tongue, but some of them are scattered over the dorsum. These are smaller than the vallate papillae but larger than the filliform papillae. Each papilla consists of a narrow pedicle and a large rounded head. They are distinguished by their bright red colour. 3. Filliform papillae Conical papilla Cover the presulcal area of the dorsum of the tongue and gives it a characteristic velvety appearance. They are the smallest and most numerous of the lingual papillae. Each are pointed and covered with keratin The apex is often split into filamentous processes.

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Fifth cranial nerve Have a large sensory root and a small motor root. Motor root arises – arises from the lateral aspect of lower pons (cranially)  the motor root cross the apex of the petrous temporal bone beneath the superior petrosal sinus, to enter the middle cranial fossa. Sensory root – arises from the lateral aspect of lower pons (caudally). RELATIONS Medially (a) internal carotid artery (b) posterior part of cavernous sinus Laterally - middle meningeal artery Superiorly - parahippocampal gyrus Inferiorly motor root of trigeminal nerve (b) greater petrosal nerve (c) apex of the petrous temporal bone (d) foramen lacerum.OPTHALIMIC DIVISION Terminal branches of Ophthalmic division of trigeminal nerve, are 1. Frontal Supratrochlear Supraorbital 2. Nasociliary Branch of ciliray ganglion 2-3 long ciliary nerves Posterior ethmoidal Infratrochlear Anterior ethmoidal 3. Lacrimal Branches From main trunk Meningeal branch Nerve to medial pterygoid From the anterior trunk Sensory branch Buccal nerve Motor branch Masseteric Deep temporal nerve Nerve to lateral pterygoid From the posterior trunk Auriculotemporal Lingual Inferior alveolar nerves

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Trigeminal Nerve

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COTTON-WOOL APPEARANCE Active phase showing disorganised bone architecture with numerous, large, multinucleated osteoclasts. The stroma is vascular and fibrous The late phase features thick trabeculae with a prominent mosaic pattern of prominent, hematoxyphilic, cement lines at the interfaces of episodes of resorption followed by deposition. Paget disease showing very prominent blue cement lines. The lamellae are arranged haphazardly giving an overall effect of a jigsaw puzzle.

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Hume- “caries is essentially a progressive loss by acid dissolution of the apatite component of the enamel then the dentin or of the cementum then dentin.” According to location: Pit or Fissure caries Smooth Surface caries According to rapidity: Acute Chronic Arrested According to occurrence: Primary (Virgin) caries Secondary (Recurrent) caries According to the site of occurrence: Enamel caries Cemental caries. Acidogenic [ Miller’s Chemico-parasitic] theory. Proteolytic theory. Proteolysis- chelation theory.

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The lymphatic system has three functions: Fluid recovery. Immunity Lipid absorption The lymphatic vessels of the small intestine receive the special designation of lacteals or chyliferous vessels. The components of the lymphatic system are :- lymph, the recovered fluid; Lymphatic vessels, which transport the lymph; Lymphatic tissue, composed of aggregates of lymphocytes and macrophages that populate many organs of the body; and Lymphatic organs, in which these cells are especially concentrated and which are set off from surrounding organs by connective tissue capsules.

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Maxillary Second Premolar the maxillary first premolar in function Less angular ,rounded crown in all aspects. Single root Smaller crown cervico occlusally Root length is as great or greater BUCCAL ASPECT Not as long as that of the first premolar Less pointed Mesial slope is shorter than the distal slope Buccal ridge of the crown may not be so prominent whencompared with the first premolarLINGUAL ASPECT Lingual cusp is longer making the crown longer on the lingual sideMESIAL ASPECT Cusps of second premolar are shorter with the buccal and lingual cusps more nearly the same length Greater distance between cusp tips-that widens the occlusal surface buccolingually No developmental depression on the mesial surface of the crown as on the first premolar Crown surface is convex instead No deep dev. Groove crossing the mesial marginal ridgeOCCLUSAL ASPECT Outline of the crown is more rounded or oval rather than angular Central dev. groove is shorter and more irregular Tendency toward multiple supplementary grooves radiating from the central groove that may extend out to the cusp ridges Makes for an irregular occlusal surface and gives a very wrinkled appearance

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Centered in the maxilla, one on either side of median line, with mesial surface of each in contact with mesial surface of other Two in number Larger than the lateral incisor These teeth supplement each other in function, and they are similar anatomically Shearing or cutting teeth Major function is to punch and cut food material during the process of mastication These teeth have incisal ridges or edges rather than cusps such as are found on canines & posterior teeth First evidence of calcification Crown completion Eruption Root completion 3-4 months 4-5 years 7-8 years 10-11 years

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Maxillary Central Incisor

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PRENATAL GROWTH OF MANDIBLE Occurs between the 4th and 7th week of intrauterine life. 4th week of intrauterine life Formation of the head fold Following which the developing brain and the pericardium form 2 prominent bulges on the ventral aspect of the embryo. The 2 bulges are separated from each other by  a shallow depression called stomatoedum (corresponding to the primitive mouth). Floor of the stomatodeum is formed by the Buccopharyngeal membrane, which separates the stomatodeum from the foregut.Soon, mesoderm covering the developing forebrain proliferates, and forms a downward projection that overlaps the upper part of the stomatodeum – this downward projection is called frontonasal process.

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Developmental Of The Mandible

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Since the formation of various parts of the face involves fusion of diverse components. Occasionally this fusion can be incomplete  give rise to various anomalies MANDIBULOFACIAL DYSOSTOSIS OR FIRST ARCH SYNDROME - Entire first arch may remain underdeveloped on one or both sides, affecting  Lower eyelid  Maxilla  Mandible  External ear. - Prominence of the cheek is absent - Ear is displaced ventrally and caudally

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Normal Cells and Tissues

1. Normal Cells and Tissues Dr. Amitha G, BDS, MDS Oral and Maxillofacial pathology

2. Content  Epithelial cells  Layers of epithelium  Skin and oral mucous membrame  Connective tissue  Arteries  Nevers  Muscle  Nucleus  Sebaceous glands  Hyaline cartilage  Fibro cartilage  Elastic cartilage  Chondrocyte

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21. Types of Cartilage