Oral mucous membrane /certified fixed orthodontic courses by Indian dental academy

Oral mucous
membrane
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

CONTENTS;

* Definition.
* Development.
* Functions.
* Classification.
* Microscopic features.
* Structure of the mucosa.
* Blood supply.
* Nerve supply.
* Junctions in oral mucosa
.

 * Age changes.
* Clinical examination.
* Prosthodontic
considerations .
*Clinical significance .
*Conclusion.
*Bibliography.

DEFINITION:
It is a protective lining of the oral
cavity consisting partly of epithelium
and partly of connective tissue.
Anatomically ,it begins at the
vermilion border of the lip and extends
upto a point where the pharynx ends.www.indiandentalacademy.com

DEVELOPMENT OF ORAL
MUCOSA:

 After the formation of
head fold in the tri-
laminar embryonic disc
the developing brain &
the pericardium form two
prominent bulging on
ventral aspect of embryo.
These bulging are
separated by
stomatodaeum. The floor
of stomatodaeum is
formed by
buccopharyngeal
membrane.
rr

 The mouth is derived
partly from the
stomatodaeum and
partly from the fore gut.
Hence its epithelium is
partly ectodermal and
partly endodermal. The
epithelium lining the
inside of the lips and
cheeks and palate is
ectodermal.the teeth
and gums are also
ectodermal in origin.
The epithelium of
tongue is derived from
endoderm

DEVELOPMENTAL
DISTURBANCES.
 FORDYCES GRANULES/FORDYCES
DISEASE- it developmental abnormaly
characterized by heterotopic collections
of sebaceous glands at various sites in
the oral cavity.

FUNCTIONS:
PROTECTION:Acts as a barrier to
microorganisms & also protects the deeper
tissues of the oral cavity from mechanical
injuries.
SENSORY FUNCTION:
1.General sensory function.
2.Function of the taste.
3.Has thirst receptors.

THERMAL REGULATION:
In animals the oral mucosa plays a
major role in regulation of body
temperature.But in human being this
function is insignificant.
ABSORPTION:
Certain substances like nitrates
are absorbed from sublingual region.www.indiandentalacademy.com

SECRETION:
Minor salivary glands in the mucosa secrete
mucus which lubricates the oral cavity.
EXCRETION:
The oral mucosa excretes certain
metabolites.
AESTHETICS:
Gingiva and lip mucosa for example enhance
facial aesthetics.

CLASSIFICATION :

 a.Masticatory mucosa.
Bound to bone and does not
stretch.Bears masticatory forces.
Ex:gingiva,hard palate
b.lining or reflecting mucosa:
It is not exposed so much to
masticatory forces.It is stretchable .
Ex:lip,cheek ,vestibule ,alveolar
mucosa, floor of the mouth, soft
palate.
I.Based on functional criteria

 c.specialized mucosa:
It performs function of sensation
of taste in addition to general sensory
function.
Ex;dorsum of tongue

.
II.Based on structure of surface layers:
a.keratinized mucosa
Ex: hard palate,gingiva..
b.Non keratinized mucosa
Ex:lip,cheek ,vestibule ,alveolar mucosa,
floor of the mouth, soft palate.

MICROSCOPIC FEATURES
Light Microscopic features
 :
It has two tissue components, a stratified
squamous epithelium and an underlying
lamina propria. Between these two there is
basement membrane.
EPITHELIUM:IT IS DIVIDED IN TO TWO
TYPES 1.KERATINIZED
2.NON KERATINIZED

 KERATINIZED EPITHELIUM:
It has four layers.
a Stratum basale
b.stratum spinosum
c.stratum granulosum
d Stratum corneum

Stratum basale:[basal layer
 *It is a first layer .
*Resting on basement membrane.
*The cells are cuboidal or columnar
.*Nuclei is deeply stained & large.
*They are arranged in a uniform row of cells.
*As cells in this layer can divide and migrate
above to form cells of other layer.
*This layer is also called as stratum
germinatum.

2.Stratum spinosum
 *Next to basal layer are found several
rows of polyhedral cells with large nuclei
called stratum spinosum .
 *The nuclei stain less intensely than
those of the basal layer.
*Individual cells are clearly outlined by
cell walls and appear to be joined by
intercellular bridges

 *These spike like intercellular
bridges give the name stratum
spinosum or prickle cell layer to this
layer.

3.Stratum granulosum:
 *Next to stratum spinosum are rows of
flattened or round cells, that contain deeply
staining granules in the cytoplasm. this row is
called stratum granulosum.
*These granules which are basophilic,
staining intensely with acid dyes such as
hemotoxylin,are keratohyaline granules

 *In parakeratinization this is indistinct.
*This is absent in non keratinized
epithelium.
*It is clearly seen only in keratinized
epithelium.

4.Stratum corneum:
 *This is the keratinized layer.
*The surface layer is composed of cells
which are flat and stain bright pink with
eosin.
*They do not contain any nuclei and this
pattern is called orthokeratinization.
*Some time the surface layer may retain
the nuclei and such a pattern is called
parakeratinization,in this nuclei are
shrunken or pyknotic.ex;a large part of
gingiva.

Nonkeratinized epithelium
 It has four layer;1.Stratum basale
2.Stratum prickle
3.Stratum
intermedium
4.Stratum
superficiale
*There is no stratum granulosum or
stratum corneum in non keratinized
epithelium

 Stratum basale:
*It is appears as in keratinized
epithelium.
Stratum prickle:
*large ovoid cells.

 Stratum intermedium:
* It has cells larger in size than the
cells of stratum spinosum of a
keratinized epithelium.
*The cells do not have spinous
appearance.

 *Stratum superfeciale:
*This layer do not show any sudden
changes from the cells in the layer
below .
*The division between two layers is
arbitrary.
*The cells do not stain intensely with
eosin.
*The cells in this layer retain their
nuclei.

BASEMENT
MEMBRANE
 *It is a structure
less layer present
between epithelium
and lamina propria.
*It is 2 micron thick.
*It is not straight
line
*It is usually
irregular

 *It is a connective tissue
of variable thickness
and supports the
epithelium
*it has a papillary
portion containing
connective tissue
papillae.
 *It has a reticular
portion having reticular
fibers, found just
beneath the basement
membrane.

LAMINA PROPRIA:

 *The reticular zone is presents a lattice
like pattern in silver staining .
 *These are immature fibres.
 *The reticular zone is always presents
but papillary zone may be absent in
certain areas like the alveolar mucosa
where papillae are absent.

SUBMUCOSA:
 *lamina propria may
directly attach to the
periosteum of alveolar
bone or may have
submucosa which in turn
attaches to underlying
structures.
*The submucosa may be
loose or firm .
*All lining mucosa have
a submucosa .
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 *Gingival &certain parts of hard palate
do not have sub mucosa.
*Glands, adipose tissue, blood vessels
& nerves which divide & extend to the
lamina propria.

Electron microscopic features:

a.keratinocytes:
*They contain fine filaments called tonofilaments.
*These are fibrous proteins synthesized by
ribosomes.
*Chemically these filaments are keratin.
*These filaments are found in keratinized
epithelial cells only.
*They are tonofibrils.
*attachment plaque:it is intercellular thickening to
which bundles of tonofilaments attach.

Functions of keratinoytes
1. Protection- covers all outer surface of the
body
2. Absorption- form the lining of all inner
surface of the body eg- digestive tract
3. Secretion- eg-glandular tissue.
4. Epithelial tissue varies depending on its
function- it may have surface specializations
on its free surface
1. Microvilli- for absorption
2. Cilia for surface transportation
5. Replicates through mitosis

 DESMOSOME;IT
ATTACHES
EPITHELIAL CELLS
TO ONE ANOTHER.
HEMIDESMOSOME
IT ATTACHES
EPITHELIAL CELLS
TO CONNECTIVE
TISSUE

Basal lamina

Separated the
epithelium and lamina
propria.It’s about 600Å
units thick.
*It has an upper clear
layer called LAMINA
LUCIDA in contact with
the basal cells of the
epithelium.

 *A lower dense layer called
LAMINA DENSA which is contact
with the reticular layer of lamina
propria
*The cells of the basal layer are
connected to Lamina Lucida by
hemidesmosomes.

Non keratinocytes
 *Certain cells with in the oral
epithelium differs from keratinocytes in
their appearance.these cells are called
non keratinocytes.
*They have a clear halo around their
nuclei.
*They are:1.melanocyte
2.langerhans cell
3.merkel cell
4.lymphocyte

1.MELONOCYTE
 *level in epithelium:basal
*specific staining reaction:do
positive;argentaphilic
*ultrastructural
features:dendritic,no
desmosomes or
tonofilaments;premelanosom
es and melanosomes
present.
*function:synthesis of
melanin pigment granules
and transfer to surrounding
keratinocytes.

2.LANGERHANS CELL:
 *Level in epithelium:predominantly suprabasal.
*Specific staining reaction:ATPase positive.
*Ultrastructural features:dendritic,no
desmosomes tonofilaments;characteristic
langerhans granules.
*Function:unknown;proposed roles have
included effete melanocyte,neural
element,regulatory cell,macrophage,and antigen
trap.

3.Merkel cell:
 *Level in epithelium:basal
*Specific staining
reaction:probably pas
positive
*Ultrastructural
features:nondendritic;sparse
desmosomes and
tonofilaments;characterstic
electron dense vesicles and
associated nerve fibers
*Function:tactile sensory cell

4.LYMPHOCYTE:
 *Level in epithelium:variable
*Specific staining
reaction:none
*Ultastructural features:large
circular nuleus;scant
cytoplasm with few
organelles;no desmosomes
and tonofilaments.
*Function:associated with
the inflammatory response in
oral mucosa.

MAIN CELL TYPES FOUND
IN THE LAMINA PROPRIA.

 1.Fibroblast:
*Morphology:stellate
or elongated with
abundant rough
endoplasmic reticulum.
*Function:secretion of
fibres and ground
substance.
*Distribution:through
lamina propria.

2.HISTOCYTE:
 *Morphology:spindle shaped
or stellate,often darkly
staining nucleus,many
lysosomal vesicles.
*Function:precursor of
functional macrophage.
*Distribution:throughout
lamina propria.

3.MACROPHAGE:
 *Morphology:round with
palely staining nucleus,many
lysosomal and phagocytic
vesicle.
*Function;phagocytic
including antigen
processing.
*Distribution:areas of chronic
inflammation.

4.MONOCYTE:
 Morphology:round with
darkly staining,kidney
shaped nuleus and
moderate amount of
cytoplasm.
*Function:phagocytic
cell,precursor of
macrophage.
*Distribution:area of
inflammation.

5.MAST CELL:
 *Morphology:round or oval
with basophilic
granules,staining
metachromatically.
*Function:secretion of
certain inflammatory
mediators
*Distribution:throughout
lamina propria,often
subepithelial.

6.Neutrophil:
characterstic lobed
nucleus .contains
Lysosomes & specific
granules.
*Function:phagocytosis &cell
killing.
*Distribution:areas of acute
inflammation with lamina
propria;may be present in
epithelium.

7.LYPHOCYTE:
darkly staining nucleus and
scant cytoplasm with a few
mitochondria.
*Function:participates in
humoral and cell mediated
immune response.
*Distribution:areas of acute
and chronic inflammation.

 8.PLASMA CELL:
*Morphology:cartwheel nucleus;intensely
pryninophilic cytoplasm with abundant rough
endoplasmic reticulum.
*Function:synthesis of immunoglobin.
*Distribution:areas of chronic inflammation,often
perivascularly.

9.ENDOTHELIAL Cell:
 *MORPHOLOGY:normally
associated with basal lamina
,contains numerous
pinocytic vesicles.
*Function:lining of blood and
lymphatic channels.
*Distribution:lining vascular
channels throughout lamina
propria.

Structure of the mucosa in
different regions of the oral
cavity:

LINING MUCOSA
 a. Soft palate:
*Epithelium:thin[150 µm]
Nonkeratinised squamous epithelium,
taste buds present.
*Lamina propria:thick with numerous
short papillae; elastic fibres forming
elastic lamina highly vascular with well
developed capillary network.
*Submucosa:diffuse tissue containing
numerous minor salivary glands and
muscle fibres.www.indiandentalacademy.com

 The posterior extent of the
maxillary denture base rest
in the soft palate.
 This area is aponeurosis, it
is strong & thick at the
junction.
 The characteristics of
aponeurosis, the overlying
mucosa, activity of the
palatal muscles & contour
of the soft palate
determines the extent &
contour of the PPS.

Prosthodontic consideration
 Overextension of the denture
beyond this area causes denture
dislodgement.

b.ventral surface of tongue:
*Epithelium:thin,Nonkeratinised stratified
squamous epithelium.
*Lamina propria:thin with numerous papillae
and some elastic fibres,a few minor salivary
glands,capilary network in subpapillary
layer,reticular layer relatively avascular.
*Submucosa:no distinct layer,the mucosa is
bound to the connective tissue surrounding
the tongue musculature.www.indiandentalacademy.com

 The sensory nerve endings permits the
tongue to detect not only the food but
also defects on teeth or denture base.
 The denture flanges must be contoured
to allow the tongue to do its normal
range of functional movement.

c.Floor of mouth:
 *Epithelium: very
thin[100µm]Nonkeratinised,stratified
*Lamina propria:short papillae, some
elastic fibres,extensive vascular
supply with short anatomizing capillary
loops.
*Submucosa:loose connective tissue
containing fat, minor salivary glands
and muscle fibers.

 It should not be over extended – soft
tissue hyperplasia may result.

ALVEOLOLINGUAL SULCUS
 It extends posterior from lingual frenum to
retromylohyoid curtain.
 Part of it is available for the lingual flange of
denture.
 It is divide in to three regions they are
1 anterior region-pre mylohyoid-it extends
from canine to canine-to record in this region
ask the patient to touch the anterior part of
the palate with the tongue

 2 middle region-mylohyoid-it extends from 1st
premolar to the 1st
molar-to record ask the
patient touch buccal mucosa on either sides.
 3 posterior region-post mylohyoid or
retromylohyoid-it extends from 1st
molar to
retromylohyoid curtain-to record ask the
patient to stretch his tongue out.

d.Alveolar mucosa:
 *Epithelium:thin Nonkeratinised stratified
*Lamina propria:short papillae, connective tissue
containing many elastic fibres,capillary loops
close to the surface supplied by vessels running
superficial to the periosteum.
*Submucosa:loose connective tissue containing
thick elastic fibres attaching it to periosteum of
alveolar process, minor salivary glands.

Labial and buccal mucosa
 *Epithelium: very thick[500µm]
Nonkeratinised stratified squamous
epithelium.
*Lamina propria:long,slender papillae; dense
fibrous connective tissue containing collagen
and some elastic fibres;rich vascular supply
giving off anastomosing capillary loops in to
papillae.
*Submucosa:mucosa firmly attached to
underlying muscle by collagen and
elastin;dense collagenous connective tissue
with fat, minor salivary glands, sometimes
sebaceous glands.www.indiandentalacademy.com

 The dentures should be well polished
so that it acts as a stabilizing factor.

LIP: Vermilion Zone
 *Epithelium:thin,orthokeratinized,strati
fied squamous epithelium.
*Lamina propria:numerous narrow
papillae;capillary loops close to
surface in papillary area.
*Submucosa:mucosa is firmly attached
to underlying muscle; some sebaceous
glands in vermilion border, minor
salivary glands and fat in intermediate
zone.

 Support- usually the edentulous patient
the lip is unsupported.
 Size -short,long,medium.
 Thicklips,Thinlips.

LIP: intermediate zone
 *Epithelium:thin,parakeratinized,stratified
*Lamina propria:long irregular papillae;
elastic and collagen fibres in connective
tissue.

Specialized mucosa

Dorsal surface of tongue:
*Epithelium:thick,keratinized and
Nonkeratinised,stratified squamous
epithelium forming three types of
lingual papillae, some bearing taste
buds.

 *Lamina propria:long papillae; minor
salivary glands in posterior portion;
rich innervation especially near taste
buds;capillary plexus in papillary
layer, large layers lying deeper.
*Submucosa:no distant layer, mucosa
is bound to connective tissue
surrounding musculature of tongue.

CIRCUMVALLATE PAPILLAE

FUNGIFORM PAPILLAE

FOLIATE
PAPILLAE

FILLIFORM
PAPILLAE

#Masticatory mucosa:
a.Gingiva:
*Epithelium:thick[250µm],orthokeratinized or
parakeratinized,stratified squamous epithelium.
*Lamina propria:long narrow papillae,dense collagenous
connective tissue;not highly vascular but long capillary
loops with numerous anastomoses.
*Submucosa:no distinct layer,mucosa firmly attached by
collagen fibres to cementum & periosteum of alveolar
process. www.indiandentalacademy.com

b.HARD PALATE
 *Epithelium:thick,orthokeratinized
[ Para keratinized in some parts],
stratified squamous epithelium thrown
in to transverse palatine ridges [rugae]
*Lamina propria:long papillae; thick
dense connective tissue, especially
under rugae;moderate vascular supply
with loose capillary loops.

 *Submucosa:dense collagenous
connective tissue attaching mucosa to
periosteoum,fat and minor salivary
glands are packed in to connective
tissue .

STRESS BERING AREAS.
 1.HARD PALATE-Major stress bearing area
in upper jaw. It is covered with a layer of
fibrous connective tissue which is most
favorable for supporting the denture because
of its firmness and position. the artificial teeth
is placed near this ridge so leverage is
minimal.

 HISTOLOGY OF HARD PALATE-epithelium
is keratinized thought. Anterolaterally the sub
mucosa contain adipose tissue,postero
laterally it contain glandular tissue.
 The mucous membrane covering the hard
palate is firmly attached to the periostum of
maxillary bone by connective tissue of sub
mucosa. this compact bone in combination
with tightly attached mucous membrane make
the palate best able to provide primary
support for upper denture.

 GLANDULAR REGION-Present on the
each side of midline in posterior part of
hard palate. Microscopically the region
contains mucous glands which are
relatively thick and they cover blood
vessels and nerves.


Prosthdontic consideration.
 This region should be covered by
denture so that it can aid in retention.

Prosthdontic consideration-
 The tissues should be recorded in resting
condition because when they displaced in
final impression they tend to return to normal
form with in the complete denture base
creating an unseating force on denture or
causing soreness in patient mouth.
 Relief of final impression tray aids in
recording these tissues in an undistorted
form.
 The secretion from palatine glands can be an
important factor in the selection of final
impression material

2.RUGAE
 -Present in the anterior part of the
hard palate they are irregularly shaped
rolls of soft tissue .
 Prosthdontic consideration of rugae-
 1)They should not be distorted in an
impression technique since
rebounding tissue tends to unseat the
denture
 .2)In rugal area the palate is set at
angle to the occlusal plane of the
residual ridges and is thinly covered
by soft tissue This area contributes to
the stress bearing role as well as towww.indiandentalacademy.com

4.INCISIVE PAPILLA.
 It covers incisive foramen and is located
on the line immediately behind and
between the areas of central incisors.
Prosthodontic consideration-relief
should be provided for the incisive
papilla in both final impression and
complete denture to prevent pressure
on the nasopalatine vessels and
nerves. www.indiandentalacademy.com

Median palatal suture.
 Sub mucosa is thin
or some times
absent.
 Mucosal layer is
practically in contact
with underlying
bone,so soft tissue
covering the median
palatal suture is non
resilient

Prosthodontic consideration.
 Little or no stress can be placed in this region
during making final impression or in CD tends
the denture to rock when vertical force are
applied to the teeth.
 This part in mouth is highly sensitive,
pressure can create excruciating pain.
 Proper relief in the impression tray or the
completed denture is essential for
accommodation of the histological nature of
the tissue.

BLOOD SUPPLY
 *The blood supply of the oral mucosa
is extremely rich & derived from
arteries that run parallel to the
surface, in the sub mucosa.
*The deeper part of the reticular layer
will supply when sub mucosa is absent

Arterial blood supply

Oral region
 1.Upper Lip
 2.Upper gingiva
Anterior
Palatal
Buccal
posterior
 Sup.Labial Artery.
Ant. Sup. Alveolar
artery
Major Palatine artery
Buccal artery.
Post. Sup. Alveolar
artery.

 3.Hard Palate
 4.Soft Palate
 Major Palatine Artery
 Sphenopalatine Artery
 Nasopalatine Artery
 Minor Palatine Artery

 5.Cheek  Buccal Artery
 Some Terminal
Branches of
Facial Artery
 Infra orbital
Artery
 Posterior
Alveolar Artery

 6.Lower Lip  Inferior Labial
Artery
 Mental Artery
 Branches of
Inferior Alveolar
Artery

 7.Lower Gingival
Anterior Buccal
Anterior Lingual
Posterior Buccal
 Mental Artery
 Incisive Artery &
Sublingual Artery
 Inferior Alveolar
Artery & Buccal
Artery
 Inferior Alveolar &
Sublingual Artery

 8.Floor of Mouth
 9.Tongue
{dorsal & ventral
surface}
Anterior 2/3 rd
Posterior 1/3 rd
 Sublingual Artery
 Deep Lingual
Artery
 Dorsal Lingual
Artery, to base of
tongue, about
posterior 1/3rd
.

Nerve supply
 Oral region:
 1.upper lip &
vestibule
 2.upper gingival
 Innervations:
 Infraorbital branch of
maxillary nerve.
 Anterior, posterior
and middle superior
alveolar branches of
maxillary nerve

 3.hard palate

4.soft palate
 Greater, lesser &
sphenopalatine
branches of
maxillary nerve.
 Lesser palatine
branch of maxillary
nerve;tonsillar
branch of
glossopharyngeal
nerve;nerve of
pterygoid
canal[taste]
[originatig from
facial nerve]

 5.cheek  Infraorbital &
superior alveolar
branch of maxillary
nerve;buccal branch
of mandibular nerve;
possibly some
terminal branches of
facial nerve.

 6.lower lip &
vestibule

7.lower
gingival;
buccal,lingual
 Mental branch of
inferior alveolar
nerve; buccal
branch of
mandibular
nerve.
 Inferior alveolar,
buccal branch of
mandibular
nerve; sublingual
branch of lingual
nerve.www.indiandentalacademy.com

 8.anterior 2/3rd
of
tongue
 9.posterior 1/3rd
of
tongue, facial &
tonsillar
 Lingual branch of
mandibular
nerve[taste].
 Glossopharyngea
l nerve[taste &
general
sensation]

Junctions in the oral mucosa

1.Mucocutaneous junction
 *It is junction between skin and
mucosa.
*It is also called as red zone or
vermilion zone.
*In young persons this is sharply
demarcated, but as a person is
exposed to ultraviolet rays, the border
becomes diffuse and poorly defined.

2.MUCOGINGIVAL JUNCTION
 *It is junction between masticatory
mucosa and lining mucosa.
*It is more abrupt in the junction
between attached gingival and alveolar
mucosa.

 *The junction is clinically identified by
mucogingival groove and the from the
bright pink of alveolar mucosa to the
paler pink of gingival.

3.DENTO GINGIVAL JUNCTION
 *It is junction between the gingival and
the tooth.
*This junction is made up of junctional
epithelium.
*In younger ages the junction on the
enamel, as in older age the junction on
the cementum.

AGES CHANGES
 1 Clinically, the oral mucosa of an
elderly person often has a smooth and
dry surface than that of youngster.
2 Histological the epithelium appears
thinner,and a smooth of the
epithelium-connective tissue interface
results in the flattening of epithelial
ridges.

 3 The dorsum of tongue may show a
reduction in the number of filliform
papillae.
4 Decreased epithelial proliferation &
decreased rate of tissue turnover.

5 Langerhan’s cells become fewer with
age.
In elderly persons, nodular varicose
veins on the ventral surface of the
tongue.
In lamina propria decreased cellularity
with increase in collagen.

 6 Increase sebaceous glands of lips &
cheek.
7 Atrophy of minor salivary glands with
fibrous replacement.
9 Post menopausal woman-present
symptoms such as dryness of mouth,
burning sensation & abnormal taste.

Clinical examination
 1 Normal healthy of oral mucous
membrane is pale pink , surface is
smoother & moist.
2 Sebaceous glands are present in the
upper lip and buccal mucosa,
occasionally alveolar mucosa and
dorsum of tongue.They appear as pale
yellow spots and are some times called
Fordyce's spots.

 3 A slight whitish line occurs along the
buccal mucosa in the occlusal plane is
called Linea alba buccalis.

Prosthodontic
consideration
 There is a wide range in the
consistency of the oral mucosa from
patient to patient.
 Some patients have alveolar ridges
covered with thick, resilient mucous
membrane; others have thin atrophic
membranes with little sub epithelial
connective tissue.

 Moderate over extension of denture
flange in one patient will produce little
discomfort, no ulceration, and perhaps
a hyperplasic response from the tissue.
In other patient there will be early
ulceration and delayed repair.

 The redness is indicative of
inflammation and can be of varying
degrees. It can be related to an ill fitting
denture, underlying infection, a
systemic disease such as diabetes or
chronic smoking.

 It is important to determine cause and
remove the irritant because successful
impression making is not possible until
the inflammation is under control.
 White patches, which most often are
keratotic areas caused by denture
irritation.

 The sub mucosa varies in thickness and
consistency and it is responsible for
supporting denture. When it is thin, it easily
gets traumatized. When it is loosely
attached & inflammed it gets easily
displaced.
 In denture wearers, keratinization is
reduced and stratum corneum of epithelium
is thinner. This reduces the resistance of
epithelium to trauma.www.indiandentalacademy.com

 The oral mucousa shows adaptation to
function.The area of mucosa available to
receive load from CD is 22.9cmsq in maxilla
& 12.25cmsq in mandible.support areas for
denture-should have keratinized mucosa with
lamina propria tightly bound to the bone
composed of dense collagen to withstand
stresses.Relief areas – are areas of
submucosa with

Clinical significance
*The lining mucosa of the lips & cheeks are soft
& pliable where as gingiva & hard palate are
covered by firm & immovable layer.
*Fluid like local anesthesia can be easily
introduced into loose lining mucosa, but L.A in to
masticatory mucosa is difficult & painful.
.

*Lining mucosa gapes when incised & require
suturing, but masticatory mucosa does not.
*The accumulation of fluid with inflammation is
obvious & painful in the masticatory mucosa, but
in lining mucosa the fluid disperses &
inflammation will not be evident.

CONCLUSION
It is essential to know the
structure of oral mucosa in the different
regions of the oral cavity. So that it aids
in clinical practice, proper prosthesis
designing & successful treatment.

BIBLIOGRAPHY
1.Text book of oral histology & embryology-
by bhasker sn 11th
edition
2.Oral histology,inheritance & development-by
d.vincent provenza &werner seibel
3.Oral histology,development structure& function-
by a.r.ten cate 2nd edition
4. Oral development and histology-
james k avery
5.Text book of complete denture-
hartwell 5th
edition
6.Prosthodontic treatment for edentulous patient-
boucher 9th
edition
7.Essentials of complete denture prosthodontics
-winkler s 2nd
edition

Oral mucous membrane /certified fixed orthodontic courses by Indian dental academy

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