This document provides an overview of a presentation on salivary glands. It discusses the classification, composition, functions, and anatomy of salivary glands. It also covers the formation and collection of saliva, conditions affecting salivation, salivary markers for periodontal diagnosis, roles of salivary enzymes and hormones, and the potential for saliva as a future diagnostic fluid. Biomarkers in saliva are classified and salivary substitutes are briefly mentioned.
This Presentation includes systematic compilation of the anatomy, physiology, biochemistry and pathology related to saliva and salivary glands. it also mentions about the role of saliva in dentistry. Any additions or mistakes are welcome!
Please do leave your comments and let me know if the presentations has helped you!
The presentation is available on request. Mail me at apurvathampi@gmail.com
This Presentation includes systematic compilation of the anatomy, physiology, biochemistry and pathology related to saliva and salivary glands. it also mentions about the role of saliva in dentistry. Any additions or mistakes are welcome!
Please do leave your comments and let me know if the presentations has helped you!
The presentation is available on request. Mail me at apurvathampi@gmail.com
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
Definition
Classification Of Salivary Glands
Anatomy of salivary glands
Development of salivary glands
Structure Of Salivary Glands
Histology of major and minor salivary glands
It is a presentation in detail about the strongest structure of the oral cavity "ENAMEL". It is a simple topic but people find it difficult to learn about it. I hope my presentation is a simple method to learn about it. I would like to thank my professors for assign me this project and i learn't a lot from it and still learning my basics daily.
Amelogenesis is the formation of enamel. During amelogenesis, the ameloblast (enamel-forming cells) undergo various stages i.e the life cycle of ameloblast.
For more content check out my blog: www.rkharitha.wordpress.com "a little about everything dental"
SALIVA AS A DIAGNOSTIC TOOL
- DEFINITION
- PROPERTIES OF SALIVA
- COMPOSITION
- FUNCTION OF SALIVA
- PRODUCTION OF SALIVA
- REGULATION OF SALIVARY SECRETION
- APPLIED PHYSIOLOGY
- COLLECTION METHOD AND DEVICE
- DIAGNOSTIC APPLICATION
- CONCLUSION
- REFERENCES
Saliva - applied physiology and its role in dental cariesKarishma Sirimulla
this seminar includes formation of saliva,factors effecting salivary flow,various conditions associated with flow of saliva and most importantly role of saliva in dental caries.remineralization and demineralization balance maintained by saliva
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
Definition
Classification Of Salivary Glands
Anatomy of salivary glands
Development of salivary glands
Structure Of Salivary Glands
Histology of major and minor salivary glands
It is a presentation in detail about the strongest structure of the oral cavity "ENAMEL". It is a simple topic but people find it difficult to learn about it. I hope my presentation is a simple method to learn about it. I would like to thank my professors for assign me this project and i learn't a lot from it and still learning my basics daily.
Amelogenesis is the formation of enamel. During amelogenesis, the ameloblast (enamel-forming cells) undergo various stages i.e the life cycle of ameloblast.
For more content check out my blog: www.rkharitha.wordpress.com "a little about everything dental"
SALIVA AS A DIAGNOSTIC TOOL
- DEFINITION
- PROPERTIES OF SALIVA
- COMPOSITION
- FUNCTION OF SALIVA
- PRODUCTION OF SALIVA
- REGULATION OF SALIVARY SECRETION
- APPLIED PHYSIOLOGY
- COLLECTION METHOD AND DEVICE
- DIAGNOSTIC APPLICATION
- CONCLUSION
- REFERENCES
Saliva - applied physiology and its role in dental cariesKarishma Sirimulla
this seminar includes formation of saliva,factors effecting salivary flow,various conditions associated with flow of saliva and most importantly role of saliva in dental caries.remineralization and demineralization balance maintained by saliva
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Here saliva as a diagnostic biomarker has been explained via this powerpoint . extraction of saliva and diagnostic equipments and techniques are explained here by Dr Harshavardhan Patwal
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 hypotonic.
topic includes salivary glands, structure & duct system of salivary glands, properties & composition of saliva, functions of saliva, regulation of salivary secretion, effect of drugs & chemicals on salivary secretion, saliva & oral biofilm, applied physiology.
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
L-PRF for increasing the width of keratinized mucosa around implants: A split...MD Abdul Haleem
Journal Club Presentation: L-PRF for increasing the width of keratinized mucosa around implants: A split-mouth, randomized, controlled pilot clinical trial.
Interproximal tunneling with a customized connective tissue graft a microsurg...MD Abdul Haleem
Journal Club Presentation - Interproximal Tunneling with a Customized Connective Tissue Graft A Microsurgical Technique for Interdental Papilla Reconstruction.
Releasing Incisions Using Upward-Motion Scissors Technique for Flap Mobilizat...MD Abdul Haleem
Journal Club Presentation - Releasing Incisions Using Upward-Motion Scissors Technique for Flap Mobilization for Guided Bone Regeneration or Periodontal Surgery: Technical Introduction and a Case Report.
Analysis of buccolingual dimensional changes of the extraction socket using t...MD Abdul Haleem
Journal Club Presentation - Analysis of buccolingual dimensional changes of the extraction socket using the "ice cream cone" flapless grafting technique
Entire papilla preservation technique in the regenerative treatment of deep i...MD Abdul Haleem
Journal Club Presentation - Department of Periodontology and oral implantology - Entire papilla preservation technique in the regenerative treatment of deep intrabony defects: 1-Year results
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. PRESENTATION BY: Dr. Mohamed Abdul Haleem
2nd Year Perio PG
KVG Dental college & Hospital,
Sullia.
3. CONTENTS
1. Introduction
2. Classification of salivary gland
3. Composition of saliva
4. Functions of saliva
5. Properties of saliva
6. Anatomy of salivary gland
7. Salivary gland structure
8. Formation of saliva
9. Collection of saliva
4. CONTENTS
10.Conditions affecting salivation
11.Salivary markers for periodontal diagnosis
12.Role of salivary enzymes
13.Salivary hormones
14.Saliva as a future diagnostic fluid
15.Biomarker
16.Classification of biomarker
17.Salivary substitutes
18.Conclusion
19.References
5. INTRODUCTION
• Glandular tissues of head and neck comprise lacrimal,
salivary, thyroid, parathyroid and thymus glands.
• Salivary glands are of utmost importance to the dentist.
There are three pairs of major salivary glands and
numerous minor salivary glands.
• Their salivary secretion ranges up to 800-1500 ml which
requires 2400 swallows per day.
6. INTRODUCTION
• The oral environment to a large degree is regulated by
saliva.
• Saliva with its unique properties have been implicated not
only in dentistry but also in various other fields of medicine
as a potential diagnostic tool.
7. CLASSIFICATION OF SALIVARY GLAND
1.Based on anatomic location
– Parotid gland
– Sub mandibular gland
– Sub lingual gland
– Accessory glands (labial,
lingual, palatal, buccal,
glossopalatine and retromolar)
2. Based on size and amount of
secretion
– Major salivary glands
– Minor salivary glands
8. 3. Based on type of secretion
– Serous
– Mucous
– Mixed
Parotid glands - Purely serous
Von Ebner’s Glands - Purely serous
Palatine, Glossopalatine - Purely mucous.
Posterior part of the tongue - Purely mucous
Submandibular-Predominantly serous, Mixed
Sublingual - Predominantly mucous , Mixed
Labial, Buccal, Lingual - Mixed
9. COMPOSITION
Parameter Characteristics
Volume 600-1000ml/day
Electrolytes Na+, K+, Cl-, Ca2+, Mg2+and F-
Secretory
proteins/peptides
Amylase, proline-rich proteins, mucins,
histatin, cystatin, peroxidase, lysozyme,
lactoferrin.
Immunoglobulins Secretory immunoglobulins A,
immunoglobulins G and M
Small organic Glucose, amino acids, urea, uric acid, and lipid
molecules
Other components Epidermal growth factor, insulin, cyclic
adenosine monophosphate-binding proteins,
and serum albumin
10. • Saliva is made up of approx. 99% of water.
• Organic components
Protein
200mg/100ml.
enzymes, immunoglobulins, mucins,
traces of albumin and polypeptides
and glycopeptides.
-amylase{Ptyalin}
60-120 mg/100 ml in parotid.
25 mg/100ml in submandibular.
Immunoglobulins
Ig A
Ig G
Ig M
14. PROPERTIES OF SALIVA
• Consistency : Slightly cloudy due to
presence of mucins and other cells
• PH : Usually slightly acidic (5-8), On
standing or boiling, it loses Co2 and
becomes alkaline
• Specific gravity : 1.0024 – 1.0061
• Freezing point :0.07 – 0.34 degree
Celsius
• Osmotic pressure : ( 700-1000m
osmol/litre )
16. Parotid gland
Largest of all the salivary glands
Purely serous gland that produce thin , watery amylase rich saliva
Superficial portion lies in front of external ear & deeper portion
lies behind the ramus of mandible
Stensen's Duct (Parotid Papilla) opens out adjacent to maxillary
second molar.
17. Submandibular Gland
Second largest salivary gland
Mixed gland
Located in the posterior part
of floor of mouth, adjacent to
medial aspect of mandible &
wrapping around the posterior
border of mylohyoid muscle.
Wharton's Duct opens
beneath the tongue at sub-
lingual caruncle lateral to the
lingual frenum.
18. Sublingual Gland
Smallest salivary gland
Mixed gland but mucous
secretory cells predominate.
Located in anterior part of floor
of mouth between the mucosa and
mylohyoid muscle
Opens through series of small
ducts (ducts of rivinus) opening
along the sub-lingual fold & often
through a larger duct (bartholin’s
duct)
19. The minor salivary glands:
1.Estimated numbers is 600-1000.
2.Exist as small, discrete, aggregates of
secretory tissue present in the
submucosa throughout most of the oral
cavity, except the gingival & anterior part
of the hard palate.
3.Predominantly mucous glands, except for
Von Ebners glands (purely serous).
4.Here intercalated & striated ducts are
poorly developed.
20. VASCULAR SUPPLY
PAROTID GLAND
Arterial: Ext.Carotid Artery and its branches
Venous: Ext.Jugular Vein
Lymphatic: Parotid Nodes Upper deep
cervical nodes
SUBMANDIBULAR GLAND
Arterial: Facial Artery , Lingual Artery
Venous: Common Facial Vein /Lingual Vein
Lymphatic: Submandibular Lymph nodes
SUBLINGUAL GLAND
Arterial: Lingual and Submental Arteries
Venous: Lingual Vein
21. INNERVATION
Parasympathetic
innervation to major
salivary glands
Otic ganglion suplies the
parotid gland.
Submandibular ganglion
supplies the other major
glands.
Sympathetic innervation
Promotes the flow of
saliva and stimulates
muscle contraction at
salivary ducts
22. Regulation of salivary secretion
Afferent signals from sensory receptors in mouth
(Trigeminal, facial, glossopharyngeal nerves)
Salivary nuclei in the medulla oblongata of brain
Parasympathetic nerve bundle & sympathetic nerve
bundle
salivary glands
23. Salivary Gland Structure
• Composed of parenchymal elements supported by connective tissue
• The types of cells found in the salivary glands are duct system cells,
acinar cells, mucous cells and myoepithelial cells.
24. • Inter cellular canaliculi : These are the extensions
of the lumen of the end piece between adjacent
secretory cells that serve to increase the terminal
surface area available for secretion.
• Secretory end pieces: branched ducts,
terminating in spherical or tubular secretory end
pieces/ acini.
• Intercalated duct : main duct connecting
acinar/mucous secretions to rest of the gland, not
involved in modification of electrolytes.
• Striated duct: electrolyte regulation in
reabsorbing sodium.
• Excretory duct: continuing sodium reabsorption
and secreting potassium.
25. FORMATION OF SALIVA
Formation of saliva occurs in 2 stages.
Stage 1 : Production of primary saliva from the
cells of secretory end pieces & intercalated
ducts, which is an isotonic fluid
Stage 2 : The primary saliva is modified as it
passes through the striated & excretory ducts
mainly by reabsorption & secretion of
electrolytes. The final saliva that reaches the oral
cavity is hypotonic.
26. Why saliva???
Advantages:
• Non – invasive
• Limited training
• No special equipment
• Potentially valuable for children
and older patients
• Cost effective
• Eliminates the risk of infection
• Easy, No pain, No needle prick,
Fast
• Screening of large population
No Pain
COLLECTION OF SALIVA
27. University of Southern California School of Dentistry
guidelines
• Unstimulated whole saliva collection always should precede
stimulated whole saliva collection.
• The patient is advised to refrain from intake of any food or beverage
(water exempted) one hour before the test session.
• Smoking, chewing gum and intake of coffee also are prohibited
during this hour.
• The subject is advised to rinse his or her mouth several times with
distilled water and then to relax for five minutes.
• Keep his mouth slightly open and allow saliva to drain into the tube.
• Should last for five minutes
28. Unstimulated flow
• Resting salivary flow―no external stimulus
oTypically 0.2 mL – 0.3 mL per minute
oLess than 0.1 mL per minute means the person has
hyposalivation
30. Stimulated Flow
• Response to a stimulus - usually taste,
chewing or medication
oTypically 1.5 mL – 2 mL per minute
oLess than 0.7 mL per minute is considered
hyposalivation
32. PASSIVE DROOL
• Passive drool is highly recommended because it
is cost effective and approved for use with
almost all analytes.
• To avoid problems with analyte retention or the
introduction of contaminants, use only high
quality polypropylene vials for collection, such
as 2 ml cryovials.
• The vials used must seal tightly and be able to
withstand temperatures as low as -80ºC.
33. • Repeat as often as necessary until sufficient sample is collected.
• One mL (excluding foam) is adequate for most tests.
• Collection of samples to be analyzed for multiple analytes may
require larger vials.
34. Salimetrics Oral Swab (SOS)
• Used in participants who are not willing or
able to drool saliva into a vial.
• The saliva samples can be analyzed for
cortisol, testosterone, α-amylase,
chromogranin A, cotinine, C-reactive
protein or SIgA using Oral.
• The SOS also helps filter mucus from the
sample which help improving
immunoassay results.
39. DIAGNOSTIC APPLICATIONS
Serum constituents(i.e., drugs and hormones) reach saliva
through,
– the salivary glands
– GCF outflow
Saliva is used for the diagnosis of:
1. Hereditary Diseases
2. Autoimmune Diseases
3. Malignancy
4. Infectious Diseases
5. Drug Monitoring
6. Monitoring Of Hormone Levels
7. Diagnosis Of Oral Disease With Relevance For Systemic
Diseases
40. DISADVANTAGES
• Samples are subject to bacterial
degradation over time.
• Absorbing specimens on cotton
may contribute interfering
substances to the extract
• Interpretation of saliva assays is
still difficult
• Contamination from bleeding
gums
41. Role of salivary enzymes
• Salivary enzymes can be produced by salivary glands, oral micro
organisms, PMNs, oral epithelial cells or be derived from GCF.
• Attempts have been made to correlate enzymatic activity in human
saliva with periodontal status.
• Studies have also assessed changes in salivary enzyme activity in
response to periodontal therapy.
• Enzymes may alter bacterial receptors & thus affect bacterial
attachment on the tooth (Gibbons & Etherden 1982 ), or they may be
directly involved in the pathogenesis of gingivitis & periodontitis (
Dewar 1958 ).( JPR 1983 18: 559-569 )
42. • Those particularly relevant in this group of enzymes are:
1. Aspartate and alanine aminotransferases (AST and ALT)
2. Lactate dehydrogenase (LDH)
3. Gamma-glutamyl transferase (GGT)
4. Creatine kinase (CK)
5. Alkaline phosphatase (ALP)
6. Acidic phosphatase (ACP)
43. Salivary hormones :
•A workshop on the immunoassay of steroids in saliva concluded that, “
All steroids of diagnostic significance in routine clinical endocrinology
can now be measured in saliva”.
•The list of steroid hormones currently being assayed in saliva includes
cortisol, aldosterone, estriol, testosterone, progesterone etc.
•Salivary estriol measurement during pregnancy has been shown to be
an excellent means of detecting fetal growth retardation & estriol to
progesterone ratio shows promise as a predictor of preterm labor.
•Some investigators have found that salivary cortisol is a better measure
of adrenal cortical function than serum cortisol.
44.
45. What is a biomarker???
• A biomarker is an objective
measure that has been
evaluated and confirmed
either as an indicator of
physiologic health, a
pathogenic process or a
pharmacologic response to a
therapeutic intervention.
46. • Biomarkers, whether
produced by normal healthy
individuals or by individuals
affected by specific systemic
diseases, are tell - tale
molecules that could be
used to monitor health
status, disease onset,
treatment response and
outcome.
49. Locally produced
proteins of host
and bacterial
origin (enzymes,
immunoglobulins
and cytokines)
Genetic ⁄
genomic
biomarkers such
as DNA and
mRNA of host
origin
Bacteria and
bacterial
products, ions,
steroid hormones
and volatile
compounds
Salivary proteomic, genomic and microbial
biomarkers for periodontal diagnosis
50.
51.
52. Salivary proteomic approach as biomarkers
• Periodontopathic bacteria either cause degradation of
host tissue directly or activate a host response
• It initiates the release of biological mediators from host
cells and when it exaggerated it leads to host tissue
destruction
• Mediators include proteinases, cytokines and
prostaglandins. And bacteria-derived enzymes such as
collagen-degrading enzymes, elastase- like enzymes,
trypsin-like proteases, aminopeptidases and
dipeptidylpeptidase
54. • Salivary proteomic biomarkers have been
identified for three key features of the
pathogenic processes in periodontal disease –
– Inflammation
– Collagen degradation and
– Bone turnover
55. Host-derived MMPs
• Both MMP-1 (interstitial collagenase) and
MMP-8 (polymorphonuclear leukocyte-
derived collagenase) gets activated in
periodontitis.
• MMP-8, which is primarily derived from
polymorphonuclear leukocytes during active
stages of periodontitis, is a major tissue
destructive enzyme in periodontal disease
56. • An elevated level of MMP-8 was detected in
the saliva of subjects affected by periodontitis
compared with healthy patients, but the levels
of salivary MMP 1 were similar in both groups.
• Therefore, quantification of the level of MMP-
8 is a promising candidate for diagnosing and,
more importantly, predicting the progression
of this episodic disease.
57. • Other MMPs, including MMP-2, MMP-3 and
MMP-9, were also reported in the saliva of
patients affected by periodontitis
58. • Salivary biomarkers have been used to
examine the effect of lifestyle factors,
including smoking on periodontal health.
• Levels of salivary markers including
prostaglandin E2, lactoferrin, albumin,
aspartate aminotransferase, lactate
dehydrogenase, alkaline phosphatase were
significantly lower in current smokers than in
non-current smokers.
61. Alkaline phosphatase
• Three main sources:
– the actual salivary secretions
– the GCF, PMNs and tissue degradation; and
– disposed bacterial cells from dental biofilms and
mucosal surfaces
62. Alkaline phosphatase
• Significant correlation between ALP and pocket
depth & inflammation exists.
• Higher enzyme activity in individuals with
periodontal disease than non diseased
individuals.
• Periodontal destruction by measurement of
probing depth, gingival bleeding, and suppuration
were related to higher ALP levels in saliva
63. Cathepsin B
• Cathepsin B functions in proteolysis
• 100% sensitivity and 99.8% specificity
• Cathepsin B may have a potential use in
distinguishing periodontitis from gingivitis and
in planning treatment and monitoring
treatment outcomes
64. CRP
• C-reactive protein is a systemic marker released
during acute phase of an inflammatory response
and is produced by liver.
• Circulating CRP reaches saliva via GCF or salivary
glands.
• High levels of CRP are associated with chronic
and aggressive periodontal diseases.
65. Osteopontin (OPN)
• It is a Noncollagenous calcium binding glycosylated
phosphoprotein in bone matrix and is produced by
several cells including osteoblasts, osteoclasts and
macrophages.
• Kido et al (2001) demonstrated that OPN level in
saliva was increased with progression of periodontal
disease.
66. Genomic approach as diagnostic
markers
• Reports of genetic polymorphisms associated
with periodontal disease are increasing and
strong evidence supports the proposal that
genes play a role in the predisposition to and
progression of periodontal disease.
67. • A number of studies have examined links
between polymorphisms within host response
factors and aggressive periodontitis.
• By examination of the genes encoding
inflammatory cytokines such as IL-1 and TNF
α, the anti-inflammatory cytokine IL-10 and
the F c- gamma receptors.
68. • Reactive oxygen species, participate in the
pathogenesis of periodontal tissue destruction.
• DNA damage, lipid peroxidation, protein
disruption and stimulation of inflammatory
cytokine release.
• 8-hydroxy-deoxyguanosine - a product of
oxidative DNA damage, is a biomarker for
detecting periodontitis in human subjects.
69. • Till now,68 up-regulated and six down-
regulated genes was identified, including
lactotransferrin, MMP-1, MMP-3, interferon
induced-15, keratin 2A and desmocollin-1, and
this result was confirmed by real-time
polymerase chain reaction.
70. Stress biomarkers in saliva
• Salivary α-amylase
• Chromogranin A
• Salivary cortisol
71. Salivary cortisol
• Its level in saliva is lower than that in blood
• Advantage of salivary over serum cortisol
measurement is the minimisation of stress
from fear of needles during collection, which
may bias the results.
72. Salivary – α amylase &
Chromogranin A
• Both salivary CgA and a-amylase are
considered biomarkers of the stress response
by the sympatho–adreno–medullary system,
unlike cortisol, which is considered a
biomarker of stress response by the
Hypothalamic pituitary adrenal system.
73.
74. Various other diagnosis
• Candidiasis
• Risk of cardiovascular and cerebrovascular diseases
• Cystic fibrosis
• Oral squamous cell carcinoma
– protein p53
– M2BP
– MRP14
– CD59
– Profilin
– Catalase
• Breast and ovarian cancer
75. • PCR detection of H. pylori in the saliva show high
sensitivity.
• The presence of antibodies to other infectious
organisms such as Borrelia burdogferi, shigella
can also be detected in saliva.
• Detection of hepatitis A and hepatitis B surface
antigen in the saliva has been used in
epidemiological studies.
76. • In neonates the presence of Ig A is an
excellent marker of rota virus infection
• HIV antibody detection is as precise in saliva
as in serum and is both applicable in clinical
and epidemiological studies.
79. Drug monitoring in saliva
Used to check:
• Molecular size
• Lipid solubility
• The degree of ionization of the drug
• The effect of salivary Ph
• The degree of protein binding of the drug
81. Saliva and age
• With age, a generalized loss of salivary gland
parenchymal tissue loss is seen.
• Salivary acini are replaced by adipose tissue.
• Decreased production of saliva
82. RESEARCH APPLICATIONS
Research currently is being conducted to:
• To find more details on saliva as a diagnostic aid for
cancer and preterm labor.
• Check regenerative properties and functions of
growth factors found in saliva, such as EGF, TGF
83. • Saliva is an alternative to serum as a biological fluid that can be
analyzed for diagnostic purposes.
• A number of markers show promise as sensitive measures of the
disease & the effectiveness of therapy are well co-related.
• Longer - term longitudinal studies , however are required to
establish the relationship between specific markers &
progression of periodontal disease.
• Further more, analysis of saliva may offer a cost effective
approach to assessment of periodontal disease in large
populations.
CONCLUSION
84. 1. Clinical Periodontology 10th Edition; Carranza,Newmann.
2. Shafers textbook of oral pathology. 5th Edtn
3. Burkitt’s textboof of oral medicine. 11th edtn
4. Periodontology 2000 volume 34: 2004
5. Tencate’s Oral histology 6th edition
6. J. Clinical Periodontology 2003;30:752-755
7. J. Clinical Periodontology 2000,27:453-465
8. J. Periodontal Research 1990,1983
9. J. Oral Pathology Medicine 1990.
10.Dentomaxillofac Radiol 2007;36:59-62. T Bar, A Zagury, D London, R
Shacham, and O Nahlieli.
REFERENCES