This document provides an overview of the anatomy, histology, embryology, lesions, and applied aspects of the tongue. It begins with an introduction and then discusses the anatomy of the tongue including its muscles, blood supply, nerve supply, and embryological development. It also covers common tongue lesions and disorders such as infections, nutritional deficiencies, premalignant conditions, and neoplasms. Finally, it discusses the applied role of the tongue in areas such as prosthodontic examination, border molding, tooth position, and management of partial glossectomy patients.

1. TONGUE AND IT’S ROLE IN
PROSTHODONTICS
PRESENTED BY:
Dr. ADITI SHREYA
1st year Post Graduate
GUIDED BY:
Dr. KHINNAVAR POONAM K
PROFESSOR

2. CONTENTS:
• INTRODUCTION
• ANATOMY
• MUSCLES OF TONGUE
• HISTOLOGY
• EMBRYOLOGY
• TONGUE LESIONS AND DISORDERS
• APPLIED ASPECTS OF TONGUE
• CONCLUSION
• REFERENCES
16-07-2023
2

3. INTRODUCTION:
16-07-2023
3

4. Figure 11: A lateral view of the tongue, notice how it is divided by
2/3 and 1/3, which will become important when talking about nerve
innervations. From: Drake RL et al. Gray’s Anatomy for Student.

5. 16-07-2023
5
BD Chaurasia’s Human Anatomy for Dental Students. Second edition. Pg No: 245.

6. VENTRAL SURFACE OF TONGUE AND OPENING OF SALIVARY
GLANDS:
6
Neil S. Norton. Netter’s Head and Neck Anatomy for Dentistry.Second Edition. Pg
No: 384.

7. Anterior 2/3
Figure : A much more updated and modern view of the dorsal of
the tongue. From: Netter FH. Atlas of Human Anatomy.

8. 16-07-2023 8
BD Chaurasia’s Human Anatomy for Dental Students. Second edition. Pg No: 248
HISTOLOGY:

9. 16-07-2023 9
Fehrenbach, Popowics. Illustrated dental embryology,anatomy and
histology. Fourth edition. Pg No: 115-17

10. 16-07-2023 10
TASTE BUDS
TASTE PORE
SUPPORTING CELLS
TASTE CELLS

11. 16-07-2023 11
Fehrenbach, Popowics. Illustrated dental embryology,anatomy and
histology. Fourth edition. Pg No: 115-17

12. COMPARISON
S
FILIFORM FUNGIFORM FOLIATE CIRCUMVALLATE
Clinical
appearance
Most common
on body;
fine-pointed
cones giving
the tongue
velvety texture
Lesser numbers
on body;
mushroom-
shaped, small,
red dots
About 4 to 11
vertical
ridges on lateral
surface
of posterior
tongue
About 7 to 15 large,
raised, mushroom-
shaped structures
anterior to
sulcus terminalis
Histologic
features
Pointed
structure with
thick layer of
keratinized
epithelium,
overlying
core of lamina
propria; no
taste buds
Mushroom-
shaped structure
with thin layer of
keratinized
epithelium
overlying core of
lamina propria
with taste buds in
most superficial
part
Leaf-shaped
structure of
keratinized
epithelium
overlying core of
lamina propria
with taste buds in
superficial lateral
part
Mushroom-shaped
structure with
similar histology to
fungiform ,taste buds
in papilla base, and
surrounded
by a trough with von
Ebner
minor salivary glands
in submucosa
Function Possibly
mechanical
Taste Taste Taste
16-07-2023 12

13. Figure : A close-up view of the different papillae. From:
Netter FH. Atlas of Human Anatomy.

14. Circumvallate papilla.
Figure : Circumvallate papilla in vertical section, showing the
arrangement of the taste-buds and nerves. From: Henry Gray.
Anatomy of the Human Body.

15. CIRCUMVALLATE PAPILLA WITH VON EBNER
GLANDS:
16-07-2023 15
Netter’s Head and Neck Anatomy for Dentistry . Pg No: 388.

16. FUNGIFORM PAPlLLA
• Figure 5: Section of a fungiform papilla. This is the reason why they
get their name ‘mushroom-like’. From: Henry Gray. Anatomy of the
Human Body.

17. Figure 6: A filiform papilla, remember they do not
contain taste buds. From: Henry Gray. Anatomy of
the Human Body.

18. Posterior 1/3
Figure : A much more updated and modern view of the dorsal of the
tongue. From: Netter FH. Atlas of Human Anatomy.

19. MUSCLES OF TONGUE:
16-07-2023 19

20. Superior longitudinal

21. Inferior longitudinal

22. Transverse muscle

23. Vertical muscle

24. EXTRINSIC MUSCLES

25. Brennan PA, Mahadevan V, Evans BT. Clinical Head and Neck Anatomy for
Surgeons. London. CRC Press. 2016.

26. HYOGLOSSUS

29. Blood supply and venous drainage.
16-07-2023 29

30. BD Chaurasia’s Human Anatomy for Dental Students. Second edition. Pg No: 247
16-07-2023 30

31. •NERVE SUPPLY:
MOTOR NERVES: All intrinsic and extrinsic nerves
except palatoglossus supplied by hypoglossal nerve.
Palatoglossus -supplied by the cranial root of accessory
nerve through pharyngeal plexus.
16-07-2023 31
BD Chaurasia’s Human Anatomy for Dental Students. Second edition. Pg No: 247

32. • SENSORY NERVES:
16-07-2023 32

33. 16-07-2023 33
NERVE SUPPLY

34. TASTE
PATHWAY
16-07-2023 34

35. EMBRYOLOGY:
16-07-2023 35
Fehrenbach, Popowics. Illustrated dental embryology,anatomy and
histology. Fourth edition. Pg No:45-50.

36. 16-07-2023 36

37. 16-07-2023 37
Fehrenbach, Popowics. Illustrated dental embryology,anatomy and
histology. Fourth edition. Pg No: 45-50.

38. TONGUE LESIONS AND DISORDERS:
• WORKING CLASSIFICATION OF COMMON TONGUE LESIONS:
INJURY:
Physical
Thermal
Chemical
INFECTIONS:
Bacterial: Tuberculosis,scarlet fever and syphillis
Viral: HIV and Hairy leukoplakia
Fungal: Candidiasis
16-07-2023 38
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

39. DEVELOPMENTAL
DISTURBANCES:
Microglossia and aglossia
syndrome.
Macroglossia
Ankyloglossia
Cleft tongue
Fissured tongue
Median rhomboid glossitis
Benign migratory glossitis
Hairy tongue
Lingual varices
Lingual thyroid nodule.
NUTRITIONAL DEFICIENCY:
Iron deficiency anemia
Pernicious anemia
Vitamin deficiency
PREMALIGNANT:
Leukoplakia
Oral submucous fibrosis
NEOPLASM:
Squamous cell carcinoma
IMMUNOLOGICAL:
Recurrent aphthous
Pemphigus
Lichen planus
16-07-2023 39

40. INJURIES
16-07-2023 40

41. PHYSICAL INJURIES THERMAL INJURIES
16-07-2023 41
CHEMICAL INJURIES
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

42. INFECTIONS:
16-07-2023 42

43. BACTERIAL
16-07-2023 43
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

44. SYPHILLIS
16-07-2023 44

45. 16-07-2023 45

46. 16-07-2023 46

47. 16-07-2023 47

48. 16-07-2023 48

49. SCARLET FEVER
16-07-2023 49
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

50. VIRAL
RECURRENT HERPES
HAIRY LEUKOPLAKIA
16-07-2023 50

51. FUNGAL
16-07-2023 51

52. DEVELOPMENTAL DISTURBANCES
16-07-2023 52

53. MICROGLOSSIA AND AGLOSSIA SYNDROME:
16-07-2023 53
Shafer, Hine, Levy. Shafer’s Textbook of Oral
Pathology. Eighth edition. Pg No: 27-34.

54. MACROGLOSSIA:
16-07-2023 54
ETIOLOGY OF PESUDOMACROGLOSSIA:

55. 16-07-2023 55
ETIOLOGY OF TRUE MACROGLOSSIA :
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

56. 16-07-2023 56

57. ANKYLOGLOSSIA:
16-07-2023 57
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

58. KOTLOW’S ASSSESSMENT OF TONGUE TIE:
Based on the length of free tongue:
• CLASS I: Mild ankyloglossia:12-16 mm
• CLASS II: Moderate ankyloglossia: 8-11 mm
• CLASS III: Severe ankyloglossia: 3-7 mm
• CLASS IV: Complete ankyloglossia: less than 3 mm.
16-07-2023 58
Chaubal T V, Dixit M B. Ankyloglossia and its management. J Indian Soc
Periodontol. 2011;45(3):270-2.

59. A normal range of motion in tongue:
16-07-2023 59
Chaubal T V, Dixit M B. Ankyloglossia and its management. J Indian Soc
Periodontol. 2011;45(3):270-2.

60. FISSURED TONGUE:
16-07-2023 60
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

61. BENIGN MIGRATORY GLOSSITIS:
16-07-2023 61
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

62. HAIRY TONGUE:
16-07-2023 62
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

63. LINGUAL VARICES:
16-07-2023 63
Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition. Pg No: 27-34.

64. NUTRITIONAL
DEFICIENCIES
16-07-2023 64

65. • Chronic iron deficiency is
associated with Plummer
Vinson syndrome where
tongue is very painful with
burning sensation.
• The tongue is inflamed
and beefy red, smooth or
bald due to atrophy of
papilla, hence called as
Hunter’s glossitis.
• Vitamin B12 deficiency
associated with pernicious
anemia results in
inflammation of the
tongue with beefy red,
atrophy of papilla and
soreness resulting in
smooth tongue.
16-07-2023 65
Niacin
deficiency(Pellagra)-
black tongue
Riboflavin deficiency-
Magenta tongue

66. PREMALIGNANT LESIONS
16-07-2023 66

67. LEUKOPLAKIA: ORAL SUBMUCOUS
FIBROSIS:
16-07-2023 67
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

68. 16-07-2023 68
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

69. NEOPLASM
16-07-2023 69

70. • Squamous cell carcinoma
16-07-2023 70
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

71. IMMUNOLOGICAL DISORDERS
16-07-2023 71

72. • Oral lichen planus Pemphigus
16-07-2023 72
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

73. • Recurrent aphthous stomatitis
16-07-2023 73
Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common Superficial Tongue
Lesions. Indian Journal of Clinical Practice. 2013;23(9):534-42.

74. APPLIED
ASPECTS OF
TONGUE:
16-07-2023 74

75. EXAMINATION:
16-07-2023 75
Sheldon Winkler. Essentials of Complete Denture Prosthodontics. Second edition.
Pg No: 50.

76. HOUSE’S CLASSIFICATION OF TONGUE
SIZE:
16-07-2023 76
16-07-2023 76
CLASS I CLASS II
CLASS III

77. CLASS I CLASS II
CLASS III
16-07-2023 77
WRIGHT’S CLASSIFICATION OF
TONGUE POSITION:

78. TONGUE MOVEMENT
16-07-2023 78

79. ROLE OF TONGUE IN BORDER MOLDING:
16-07-2023 79
Zarb-Bolender. Prosthodontic Treatment for Edentulous Patients. Complete denture and
implant supported prosthesis. Twelfth edition. Pg No: 246-48.

80. ROLE OF TONGUE IN TOOTH POSITION
AND ARRANGEMENT:
16-07-2023 80
Zarb-Bolender. Prosthodontic Treatment for Edentulous Patients. Complete denture and
implant supported prosthesis. Twelfth edition. Pg No: 316-18.

81. 16-07-2023 81
Zarb-Bolender. Prosthodontic Treatment for Edentulous Patients. Complete denture and
implant supported prosthesis. Twelfth edition. Pg No: 316-18.
1-2 mm

82. GLOSSECTOMY AND
MANAGEMENT
16-07-2023 82

83. 16-07-2023 83
Ansarin M, Bruschini R, Navach V, Giugliano G, Calabrese L, Chiesa F.et al. Classification
of Glossectomies: Proposal for tongue cancer resections. Head and Neck.2019;41:821-
27.

84. 16-07-2023 84

85. • The prosthodontic management of glossectomy patients depends on
the size of the defect.
• partial tongue resection -Palatal Augmentation Prosthesis to lower
the palatal vault.
• Total glossectomy - mandibular tongue prosthesis.
16-07-2023 85
Kumar P R, Hasti A, Jagadessh H G, Thoudam B. Rehabilitation of a partial
glossectomy patient : Palatal augmentation prosthesis. J Indian Prosthodont
Soc. 2019;19(2):190-6.

86. PROSTHODONTIC MANAGEMENT OF PARTIAL
TONGUE RESECTION:
16-07-2023 86

87. 16-07-2023 87

88. 16-07-2023 88

89. 16-07-2023 89

90. PROSTHODONTIC MANAGEMENT OF TOTAL
GLOSSECTOMY:
16-07-2023 90
Bhirangi P, Somani P, Dholam K P, Bachher G. Technical considerations in
rehabilitation of an edentulous total glossectomy patient. Int J Dent.2012;1-4.

91. 16-07-2023 91

92. 16-07-2023 92

93. 16-07-2023 93

94. 16-07-2023 94

95. 16-07-2023 95

96. 16-07-2023 96

97. 16-07-2023 97

98. 16-07-2023 98

99. 16-07-2023 99

100. 16-07-2023 100
[Table/Fig-1]: Tongue prosthesis for swallowing.
[Table/Fig-2]: Tongue prosthesis for speech.
[Table/Fig-5]: Tip of the tongue pros- thesis (silicone).
[Table/Fig-6]: Mushroom type retention; [Table/Fig-7]: Tongue prosthesis.

101. 16-07-2023 101
[Table/Fig-8]: Maxillary denture with palatal augmentation prosthesis;
[Table/Fig-9]: Mandibular denture with wax pattern.

102. 16-07-2023 102

103. CONCLUSION
• Tongue is an important organ that helps in mastication, deglutition
and speech. Examination of tongue plays a major role during oral
examination of soft tissues. The knowledge about anatomy,
development and diseases associated with tongue helps in
identifying the same leading to pathological changes of tongue at
earliest.
16-07-2023 103

104. REFERENCES:
• BD Chaurasia’s Human Anatomy for Dental Students. Second edition.
• Neil S. Norton. Netter’s Head and Neck Anatomy for Dentistry. Second
Edition.
• Fehrenbach, Popowics. Illustrated dental embryology,anatomy and
histology. Fourth edition.
• Sunil A, Kurien J, Mukund A, Basheer A B, Deepthi. Common
Superficial Tongue Lesions. Indian Journal of Clinical Practice.
2013;23(9):534-42.
• Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. Eighth edition.
• Chaubal T V, Dixit M B. Ankyloglossia and its management. J Indian Soc
Periodontol. 2011;45(3):270-2.
16-07-2023 104

105. • Sheldon Winkler. Essentials of Complete Denture Prosthodontics.
Second edition.
• Zarb-Bolender. Prosthodontic Treatment for Edentulous Patients.
Complete denture and implant supported prosthesis. Twelfth edition.
• Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga, Akagaw Y. Effects
of tooth loss and denture wear on tongue-tip motion in elderly dentulous
and edentulous people. J Oral Rehabil. 2008;35:882-88.
• Denizoglu S, Yanikoglu N, Yilmaz B, Kurklu D. Effects of tongue movements
on lingual sulcus depth while border molding in mandibular complete
dentures. Indian J Dent Res. 2014;25(4):439-44.
• 16-07-2023 • 105

106. • Rajeshwari1 K, Kohli S, Mathew XK. Evaluation of Resting Tongue
Position in Recently Extracted and Long Term Completely Edentulous
Patients: A Prospective Interventional Study. J Clin Diagn Res.
2017;11(4):61-63.
• Mohammad H, Shayyab A, Baqain ZH. Sublingual varices in relation to
smoking, cardiovascular diseases, denture wearing, and consuming
vitamin rich foods. Saudi Med J 2015;36(3).310-15.
• Nakazawaa Y, Kikutania Y, Igarashia K, Yajimab Y, Tamurab F.
Associations between tongue strength and skeletal muscle mass under
dysphagia rehabilitation for geriatric out patients. J Prosthodont Res.
2019;586:1-5.
16-07-2023 106

107. • Ansarin M, Bruschini R, Navach V, Giugliano G, Calabrese L, Chiesa F.et al.
Classification of Glossectomies: Proposal for tongue cancer resections. Head
and Neck.2019;41:821-27.
• Kumar P R, Hasti A, Jagadessh H G, Thoudam B. Rehabilitation of a partial
glossectomy patient : Palatal augmentation prosthesis. J Indian Prosthodont
Soc. 2019;19(2):190-6.
• Bhirangi P, Somani P, Dholam K P, Bachher G. Technical considerations in
rehabilitation of an edentulous total glossectomy patient. Int J Dent.2012;1-
4.
• Wright JE. Review article tongue‐tie. Journal of paediatrics and child health.
1995 Aug;31(4):276-8.
16-07-2023 107

108. • Koshino H, Hirai T, Ishijima T, Ikeda Y. Tongue motor skills and
masticatory performance in adult dentates, elderly dentates, and
complete denture wearers. The journal of prosthetic dentistry. 1997
Feb 1;77(2):147-52.
• Bohnenkamp DM, Garcia LT. Phonetics and tongue position to
improve mandibular denture retention: a clinical report. The Journal
of prosthetic dentistry. 2007 Nov 1;98(5):344-7.
• Chen YF, Yang YH, Lee JH, Chen JH, Lee HE, Chou TM. Tongue support
of complete dentures in the elderly. The Kaohsiung Journal of
Medical Sciences. 2012 May 1;28(5):273-8.
• Kimata Y, Sakuraba M, Hishinuma S, Ebihara S, Hayashi R, Asakage T,
Nakatsuka T, Harii K. Analysis of the relations between the shape of
the reconstructed tongue and postoperative functions after subtotal
or total glossectomy. The Laryngoscope. 2003 May;113(5):905-9.
16-07-2023 108

109. • Balaji SM. Reduction glossectomy for large tongues. Annals of
Maxillofacial Surgery. 2013 Jul;3(2):167.
• Balasubramaniam MK, Chidambaranathan AS, Shanmugam G, Tah R.
Rehabilitation of glossectomy cases with tongue prosthesis: a
literature review. Journal of clinical and diagnostic research: JCDR.
2016 Feb;10(2):ZE01.
• Garg A. Prosthodontic rehabilitation of completely edentulous
patient with partial glossectomy. The Journal of the Indian
Prosthodontic Society. 2016 Apr;16(2):204.
• Aramany MA, Downs JA, Beery QC, Aslan Y. Prosthodontic
rehabilitation for glossectomy patients. The Journal of prosthetic
dentistry. 1982 Jul 1;48(1):78-81.
16-07-2023 109

110. 16-07-2023 110

111. THANK YOU
16-07-2023 111