Misr International University

Faculty of Oral and Dental Medicine

Midterm Written Exam, Fall 2019 (Model Answer)

Course Code: HPT 201 Department: Oral Histopathology

Course Title: Oral Histology II Grades: 40 marks to be divided by 2 = 20 marks

Date: Sunday, 27/10/2010 Time: 90 minutes

Instructors: Prof. D. Nehad Samir / Ass. Prof. D. Mohamed Zayed / D. Enas Helwa/ D. Randa Mokhtar

No of questions: 4 No. of exam pages: 3 Attempt all questions

I) Complete the following table: (1 mark each = 18 marks)

Fungiform Filliform Circumvallate

Type of epithelium Non Keratinized Keratinized Non Keratinized

Location on the Tip & lateral borders In front of the sulcus

All Over
dorsal surface anteriorly terminalis

Location of taste
Top corner No taste buds Laterally
buds in the papilla

Type of taste
Sweet & Salt No Taste sensation Bitter
sensation

Nerve supply Chorda tympani Chorda tympani Glossopharyngeal

Level of papilla to Embedded within the

High High
the tongue surface surface

Course Code: HPT 201, Second Year Page 1 of 6 Sunday, 27/10/2019

 II) Explain the following sentences in no more than one paragraph: (0.5 mark
each = 6 marks)
1. Macro-anatomically the gingiva is formed of three areas, while micro-anatomically it
is formed of two areas.

Macro-anatomically, the gingiva is formed of free gingiva, attached gingiva and

gingival col (Sulcular epithelium or gingival sulcus), while micro-anatomically, it
is formed of keratinized (90%) & non-keratinized (10%) epithelia.

2. The bundle bone is also known as cribriform plate.

As it is perforated by many foramina transmitting nerves and blood vessels to the

periodontal ligament.
3. The secretion of the parotid gland differs by age.

It is pure serous gland in adults, however in infants it is mixed with few mucous
secreting units

4. Looking to an x-ray film, we can differentiate between the upper and lower jaws.

The x-ray studies permit the classification of the spongiosa into two main types:
Type I
▪ Present in the interdental and inter-radicular septa where the bone trabeculae are
arranged horizontally in a ladder like manner which is common in the mandible.
Type II
▪ The bone trabeculae show irregular arrangement, they are numerous and more
delicate and they are common in the maxilla.
▪ Below the root apices the trabeculae of the spongiosa appear radiating from the
fundus of the socket. This form is evident in the mandible and absent in the maxilla.
5. Despite the same histological structure of the taste bud in all the tongue papillae we
can taste different types of food.

Due to the presence of taste receptors in the taste pore microvilli.

6. The local anesthesia technique differs from the upper to the lower jaw.

In the anterior teeth of both jaws the cortical plates are usually thin, with absence of
spongiosa near the crest, where they fuse with the alveolar bone proper.
▪ However, the outer cortical pate is thinner than the inner one especially in the upper
jaw.
▪ The buccal cortical plates are thick and dense in the premolar and molar regions of
the lower jaw especially the outer one.
▪ In the maxilla the outer cortical plate of the same regions is thin and perforated by
many small openings through which blood and lymph vessels pass.
▪ The outer cortical plate in the premolar and molar regions of the maxilla may be
completely absent.

Course Code: HPT 201, Second Year Page 2 of 6 Sunday, 27/10/2019

 III) Choose the letter from column (B) and roman number from column (C) that
best matches the number from column (A): (1 mark each = 13 marks)

A B C

1 m vii

2 c vi

3 l xii

4 i xi

5 g xiii

6 j iii

7 b x

8 a ii

9 k iv

10 d i

11 e ix

12 h viii

13 f v

Course Code: HPT 201, Second Year Page 3 of 6 Sunday, 27/10/2019

 IV) In a table form compare between the striated & excretory duct regarding the
following: (0.5 mark each = 3 marks
Striated Duct
Location to the lobule Intra-lobular
Single layer of tall columnar
cells with basal striations and
Epithelium lining
large spherical centrally placed
nuclei.
1- They covey secretion
toward striated ducts.
2- The ductal reabsorption of
sodium and chlorides
exceeds the secretion of
Function potassium and bicarbonate.
leading to hypotonic saliva
3- Reabsorb protein
4- Secret kallikerin enzyme
5- They play a major role in
iodine metabolism.
Course Code: HPT 201, Second Year Page 4 of 6
Excretory Duct
Inter-lobular
Pseudostratified epithelium with
goblet cells.
1-They convey the salivary
secretion towards the oral cavity.
2- They have the ability to reabsorb
sodium and secrete potassium and
bicarbonate.
3- The ductal reabsorption of
sodium and chlorides exceeds the
secretion of potassium and
bicarbonate leading to hypotonic
saliva.
Sunday, 27/10/2019
 V) Saliva has an important defense mechanism on the tooth and the oral mucosa.
Discuss this statement. (3 marks)
I. Protection of the oral cavity and oral environment

Saliva extends protection to the oral cavity and its tissues in many ways.
1. The constant secretion of saliva prevents desiccation of the oral tissues. The absence of which can
cause the oral mucosa to degenerate and atrophy.
2. Its fluid like nature provides a washing action to flush away debris and the non-adherent bacteria.
3. The mucin and other glycoproteins provide lubrication for the movement of the oral tissues
against each other allowing smooth and sliding movements.
4. Saliva protects the mucosa from chemical and thermal insults by reducing the concentration and
lowering and buffering the temperature respectively.

II. Protection of the tooth:

1. washing action that flushes away non-adherent bacteria and other debris. In particular, the
clearance of sugars from the mouth limits their availability to acidogenic plaque
microorganisms.
2. Neutralize the acidity through the primary buffering system of saliva is formed by
bicarbonates (HCO3) and salivary proteins contribute to the buffering action. that help to
increase the pH,. This helps in maintaining a high pH, which is not conducive for cariogenic
bacteria to survive, ferment carbohydrate and produce acid to cause tooth decay.
3. A large group of salivary proteins called proline rich proteins inhibit the precipitation of
calcium phosphate from the saliva (plaque). So reduce caries.
4. Remineralization of tooth:
a. The resulting supersaturation of the calcium and phosphate reduces dissolution and
promotes remineralization of the tooth enamel.
b. On the surface of the tooth, a high concentration of calcium and phosphate causes
posteruptive mineralization of the enamel (inorganic increase from 96% to 98%),
increases surface hardness and resistance to demineralization.
c. Remineralization of the initial carious lesions can be enhanced by fluoride ions in
saliva.

Course Code: HPT 201, Second Year Page 5 of 6 Sunday, 27/10/2019

 5. Saliva has many antibacterial features. They are chiefly produced by the serous secretory
cells.
a. Some high molecular weight salivary glycoproteins aggregate specific strains of
oral microorganisms and/or prevent their adhesion to oral tissues, thus facilitating
their oral clearance.
b. The acinar cells secrete peroxidase and ductal system secretes thiocyanate, both of
which establish a bactericidal system in saliva.
c. Another antibacterial protein in saliva is lysozyme, an enzyme that hydrolyzes the
polysaccharide of bacterial cell walls, resulting in cell lysis.
d. An important group of defensive substances in saliva are the immunoglobulins. The
predominant salivary immunoglobulin is IgA. Salivary or secretory IgA differs
from serum IgA that is produced locally by plasma cells in the connective stroma
of the glands.
e. Another antibacterial substance found in the saliva is lactoferrin, an iron binding
protein.

Course Code: HPT 201, Second Year Page 6 of 6 Sunday, 27/10/2019