Oral Histology

Dr Yaser Abdullah
Maxillary Sinus and
Temporomandibular
Joint (TMJ)
 Maxillary Sinus
Definition: It is the largest bilateral air sinus in the skull
bones located in the body of the maxilla above
commonly the molar roots, less frequently the premolar
roots and rarely the canine root.
 Maxillary Sinus
Development of the Maxillary Sinus:
It develops in the 3rd month of intra-uterine life
where it arises as a slit-like space due to the
lateral invagination of the mucous membrane of
the middle nasal meatus. At birth, it measures
about 8 mms anteroposteriorly x 4 mms
transversely x 6 mms vertically.
 Maxillary Sinus
It gradually expands by pneumatization* of the
body of the maxilla.It reaches its full
development when the permanent dentition is
completed, although it may continues to expand
probably throughout life by its extension into the
frontal, zygomatic and alveolar processes of the
maxilla, also by extension into the maxillary
tuberosity and the zygomatic bone.
*Pneumatization: It is the hollowing out of the
maxillary sinus by bone resorption on the sinus
and bone deposition on the facial surface of the
maxilla.
 Anatomy of the maxillary sinus
-It is a variable in size, shape and position not only
from one individual to another but also in the two
sides of the same individual.
-It is a pyramidal in shape with the base is formed
by the lateral wall of he nasal cavity, the apex
extends into the zygomatic process of the maxilla,
the anterior wall corresponds to the facial surface
of the body of the maxilla, the posterior wall is
formed by the infra-temporal surface of the maxilla,
the roof corresponds to the floor of the orbital
surface and the floor is formed by the alveolar
process of the maxilla.
 Anatomy of the maxillary sinus
-The maxillary osteum: It is the main opening of the
maxillary sinus into the nose and found in the middle
meatus of the nose.
-The accessory osteum: It is the accessory opening of
the maxillary sinus and found in a lower level than the
maxillary osteum. It is slightly more advantageously
placed for drainage than the maxillary osteum.
-The average capacity of the maxillary sinus is about
15 ml.
-The average dimensions of the maxillary sinus in the
adult are about 3.4 cms anteroposteriorly x 2.3 cms
transversely x 3.3 cms vertically.
 Histological structure of the maxillary
sinus
It is lined by a thin delicate mucous membrane
which is typical of that lining the respiratory tract
composing of pseudostratified columnar ciliated
epithelium rich in goblet cells.
 Histological structure of the maxillary
sinus
Pseudostratified columnar ciliated epithelium:
It is a single of columnar epithelial cells lying on a
basement membrane which separates them
from the lamina propria which is fused with the
periosteum of the underlying bone and consists
of a loose connective tissue containg mixed
minor salivary glands .The nuclei of the epithelial
cells lie usually near the base ,while the cilia are
found at the free ends of the epithelial cells
which are responsible for withdraw out any
foreign particles.
 Histological structure of the maxillary
sinus
Goblet cells
They derived their name from their shape , they
look like a wine glass consisting of a swollen
apical end ovoid in shape and a short stalk-like
basal end which rests on the basement
membrane.
The swollen part is full of mucin, The nuclei lie
usually at the basal end.They secrete mucin that
moistens the mucosal surface of the maxillary
sinus. They are also called apocrine glands due
to they secrete their mucin by rupturing the cell
membrane which will again regenerate.
Histological structure of the maxillary
sinus
 Functions of the maxillary sinus
1-An important in vocalization and phonation.
2-Warming and moistening of the inhaled air and
contribution to olfaction.
3-Lightening the weight of the skull.
4-Production of lysozyme (antibacterial enzyme)
to the nasal cavity.
 Age changes of the maxillary sinus
1-Periapical infections of the maxillary teeth
related to the floor of the maxillary sinus can be
a cause of sinus infection.
2-It may be damaged during surgical procedures
of its close relation to the roots of the posterior
maxillary teeth.
Age changes of the maxillary sinus
3-Extension of the floor of the maxillary sinus
between the roots occurring after the loss of the
maxillary molar or premolar may be a cause of
partial fracture of the floor of the maxillary sinus
or its perforation during extraction of tooth
adjacent to the gap of the previously extracted
tooth.
Age changes of the maxillary sinus
4-The maxillary sinusitis may sustain pain to a
group of maxillary teeth or even all of the
maxillary teeth in the involved side resembling
pulpal pain due to exposure of the superior
alveolar nerve towards the sinus----may becomes
involved in the mucoperiosteal inflammation.
 Temporomandibular Joint (TMJ)
 Definition: It is a bilateral synovial joint that provides an
articulating relation between the condyle of the
mandible and the articular fossa with the articular
eminence of the temporal bone during the functional
movement of the mandible
 Development of TMJ
 The temporomandibular joint develops at about
the 3 rd month of intra-uterine life where the
mandible and temporal bones are formed
leaving a space filled with mesenchymal mass
that appears two clefts becoming the upper and
lower joint cavities and the mesenchyme in
between becomes the disc and surrounded by
the capsular ligament then the synovial
membrane of the joint cavity appears later.
 Anatomy and histological structure of
TMJ
The temporomandibular joint consists of the
following:
 1- The condyle of the mandible.
 2- The articular fossa with the articular eminence
of the temporal bone.
 3- The articular disc.
 4- The capsular ligament.
 5- The synovial membrane.
 6- The synovial fluid.
 7- The blood supply of TMJ.
 8- The nerve supply of TMJ.
 Anatomy and histological structure of
TMJ
1-The condyle of the mandible : It is composed of
sponge bone covered by a thin layer of compact
bone and covered by a layer of hyaline cartilage
lying beneath a layer of fibrous tissue.
2-The articular fossa with the articular eminence of
the temporal bone : The articular fossa is the roof
of the glenoid fossa which consists of a thin layer
of compact bone covered by a layer of fibrous
tissue, while the articular eminence is composed
of sponge bone covered with a thin layer of
compact bone and covered by a layer of hyaline
cartilage lying beneath a layer of fibrous tissue.
 Anatomy and histological structure of
TMJ
3-The articular disc: It is an oval plate of dense
avascular fibrous tissue whose periphery fused
with the capsular ligament dividing the joint cavity
completely into two main compartments (upper
and lower ).The upper compartment is also called
the temporodiscal space, and is larger and wider
giving concavoconvex shape for the upper surface
of the articular disc to fit the articular fossa and
the articular eminence of the temporal bone. The
lower compartment is also called the
condylodiscal space,and is smaller and narrower
giving concave shape for the lower surface of the
articular disc to fit the head of the mandibular
Anatomy and histological structure of
TMJ
 Anatomy and histological structure of
TMJ
4-The capsular ligament It is composed of an outer
thick fibrous layer and an inner thin synovial layer
(synovial membrane is rich in blood supply). It is
attached superiorly to the temporal bone around
the margins of the articular fossa and the
articular eminence and inferiorly to the neck of the
mandibular condyle. Its lateral part is thickened to
form a triangular band is called the
temporomandibular ligament which is attached by
its base to the tubercle of the root of the zygomaic
bone and by its apex to the lateral area of the neck
of the mandibular condyle.
Anatomy and histological structure of
TMJ
5- The synovial membrane : It is formed of two
main layers: cellular intima (1-4 layers of
synovial cells) resting upon vascular subintima
(loose connective tissue containing vascular
elements, macrophages, mast cells, fibroblasts
and fat cells) which blends with the outer fibrous
layer of the capsular ligament.
 The synovial membrane of TMJ

A: The synovial membrane. B: The margin of articular disc. C: The joint

cavity. D: The posterior surface of mandibular condyle.
 Anatomy and histological structure of
TMJ
6-The synovial fluid It is a viscous fluid produced by
the synovial cells. It is composed of plasma,
protein, mucin, and phagocytic cells (monocytes
and macrophages).
7-The blood supply of TMJ -The arterial blood supply
of the joint is from the internal maxillary artery
through its deep auricular branch and the
superficial temporal arteries. -The pterygoid
plexus provides the main drainage system.
8-The nerve supply of TMJ The nerve supply of the
joint is by the trigiminal nerve through the
auriculotemporal branch of the mandible nerve
 Functions of TMJ
It has the following functions:
a-Moving function: It allows a wide range of
movement to the mandible which including:
i-The gliding or transilatory movement is performed
by the upper compartment of the joint.
ii-The hinge or rotational movement is performed by
the lower compartment of the joint.
b-Suspensive function: The temporomandibular
ligament forms the main suspensory ligament of the
mandible during its movement.
 Functions of TMJ
c-Synovitic function: The synovial fluid provides a
liquid environment for the joint surfaces and
lubrication to reduce erosion. d-Nutritive function:The
synovial fluid provides nutrition to the articular disc
and articular surfaces.
e-Defensive function: The synovial membrane is
responsible the removal of foreign materials into the
joint cavity due to it has monocytes and
macrophages which have marked phagocytic
properties.
 Age changes of the TMJ
1-Osteoporosis is a common with advanced age.
2- Flattening of the articular surfaces with advance
age.
3-Loss of the teeth with advanced age ------ loss of
the facial height ------ upwards and forwards
posturing of the mandible.
4-Ankylosis of TMJ due to local severe trauma.