ORAL MUCOSA

Oral Histology Dent 206

Functions of oral Mucosa

Mechanical protection Barrier against microorganisms & toxins Immunological defense Lubrication Innervation

Touch Proprioception Taste Pain

Structure of Mucosa

Epithelium (vs. epidermis of skin)

Stratified squamous Ectodermal or endodermal origin

Basal lamina Lamina Propria (vs. dermis of skin)

Papillary Layer Reticular layer Loose connective tissue Contains

Submucosa (vs. subcutaneous tissue)

Glandular tissue Adipose tissue Large blood vessels and nerves

Types of Oral Mucosa

Masticatory muscosa Lining mucosa Specialized mucosa

Masticatory Mucosa

Where there is compression & friction Rough, thicker and whiter in colour compared to lining mucosa Keratinized or parakeratinized epithelium Thick lamina propria bound down directly & tightly to underlying bone Covering

Hard palate Oral surface of gingiva

Lining Mucosa

Not subject to high level of friction Soft, mobile and distensible Thinner & redder in colour compared to masticatory mucosa Non-keratinized epithelium Loose lamina propria Covering

Oral surface of cheeks, lips, alveolus, dentogingival region, floor of the mouth, ventral surface of tongue and soft palate

Specialized mucosa
Keratinized epithelium Covers

Dorsum of the tongue

Associated with taste sensation Gustatory mucosa

Vermilion zone of the lip

Epithelium

Layers

Stratum germinativum (stratum basale) Stratum spinosum (prickle cell layer) Stratum granulosum (granular layer) Stratum corneum (Keratinized or cornified layer)

Progressive maturation / differentiation process

Superficial cells are shed & replaced from below Turnover is fastest in junctional & sulcular epithelia (5 days) Followed by lining mucosa Masticatory mucosa has the slowest turnover rate

Stratum germinativum

Single cuboidal cell layer Adjacent to lamina propria The only layer where mitosis occurs Are all stem cells? Least differentiated cells Non-keratinocytes

Stratum spinosum

Several cells thick Round or ovoid cells Larger & more mature than those of s. germinativum Contain

Tonofilaments & involucrin Phospholipid granules (Odland bodies) in upper part of stratum spinosum Increased desmosomes (shrinkage during preparation gives the spiny appearance)

Stratum granulosum

Cells of further increase in maturation Cells larger & flatter Contain

Tonofilaments & tonofibrils that occupy the cytoplasm Keratohyaline granules (contain profilaggrin)

Stratum Corneum

In keratinized epithelium

Highly mature epithelial cells (squames) All cellular organelles and nucleus lost (orthokeratinzation) In gingiva, nuclei may be retained (parakeratinization) Cells are packed with Keratin Kertain consists of

Tonofilaments surrounded by Filaggrin (matrix protein)

Desmosomes are weakened to allow for shedding (desquamation) Involucrin is cross-linked to form a cornified envelop beneath plasma membrane

Stratum Corneum

In non-keratinized epithelium

No keratin Tonofilaments are less & underdeveloped Lack keratohyaline granules This layer is less distinct The outer layers of non-kertinized epithelium may be termed stratum superficiale The layers below may be termed stratum intermedium

Keratinization

Regional distribution Adaptation to abrasion by food - rough surface Whiter than nonkeratinized mucosa Ortho- vs. parakeratinization

Non-keratinocytes

10% of oral epithelial cells Lack tonofilaments & desmosomes (except Merkel cells) Appears as clear cells in routine H&E staining as they lack the cytokeratin of keratinocytes Include

Melanocytes Langerhans cells Merkel cells

Melanocytes

Located in stratum germinativum Pigment (melanin)-producing cells Derived from neural crest cells Long processes that extend through upper layers Packed with granules (melanosomes) Racial variance is due to

Melanocyte size difference Number of dendritic processes Melanosomes: granule number or size Melanin: degree of dipersion and rate of degradation

Langerhans cells

Dendritic cells Located in the layers above stratum germinativum Derived from bone marrow precursors Antigen-presenting cells Involved in contact-hypersensitivity reactions, antitumour immunity & graft rejection Contain Birbeck granules

Merkel cells

Located in stratum germinativum of masticatory epithelium Absent in lining epithelium Closed apposed to nerve fibers Thought to act as receptors Derived from neural crest cells Associated with desmosomes

Lining mucosa

Location

Mucosal surface of the Lip Soft Palate Cheeks Ventral surface of the tongue Floor of the mouth Alveolar Mucosa Frena Vestibular Fornix

Lining epithelium

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/09_big.html

Lip

Oral surface Vermilion zone Skin surface

Oral surface

Epithelium

nonkeratinized Seromucous minor salivary glands

Lamina Propria

Submucosa

Orbicularis Oris

Oral surface of the lip

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/15_big.html

Vermilion zone

Junction between skin & oral mucosa Specialized keratinized mucosa different from both skin & oral mucosa Lacks hair follicles or glandular tissue Sebaceous glands may be present at angles of the mouth Red in colour (human characteristics)

Thin epithelium Transparent Eleidin Rich blood vessels near the surface (long papillae) Junctional region with oral surface Parakeratinized

Intermediate zone

Vermilion zone

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/18_tns.html

Skin surface

Skin appendages
Hair follicles Sebaceous glands Erector pili muscles Sweat glands

Subcutaneous layer

Orbicularis Oris

Skin surface of the lip

Fordyces spots

Ectopic sebaceous glands Not associated with a hair follicle Location

Corners of the mouth Buccal mucosa Soft palate

Fordyces spots

http://www.usc.edu/hsc/dental/PTHL501/QL/d_ql_11.html

Fordyces spots

http://www.usc.edu/hsc/dental/PTHL501/QL/d_ql_14.html

Soft palate

Epithelium

Pink surface
Highly vascularized Muscles Mucous minor salivary glands

Lamina Propria

Submucosa

Cheeks

Epithelium Lamina Propria Submucosa

Fat cells Seromucous minor salivary glands Buccinator muscle

Ventral surface of the tongue

Epithelium Lamina Propria Submucosa

Connective tissue and muscle fibers mixed together

*Firmly attached membrane

Ventral surface of the tongue

Floor of the mouth

Epithelium lamina Propria Submucosa

Minor salivary glands Sublingual major salivary glands

*Loosely attached membrane

Alveolar mucosa

Epithelium

Nonkeratinized
Dermal papillae are short and thick Numerous elastic fibers

Lamina Propria

Submucosa

Loose and may contain seromucous glands

Periosteum /bone

Vestibular fornix and frena

Fornix

Loosely attached to muscle

Labial/buccal Folds of mucous membrane Contain connective tissues No muscles

Frena

Masticatory Mucosa

Location

Gingiva Hard palate

Masticatory epithelium

Attachments

Cell-to-cell

Desmosomes

Epithelium to Lamina Propria

Basal Lamina

Hemidesmosomes Anchoring Fibrils

Gingiva

Development

http://home.teleport.com/~bobh/gingiva.htm

Coalescence of reduced enamel epithelium & oral epithelium

Free (marginal) gingiva Attached gingiva Interdental gingiva Free gingival groove mucogingival junction

Three zones

Junctions

Free gingiva

Free gingiva

Surface
Smooth Keratinized Sulcular surface is not keratinized

Separated by:
Gingival sulcus from the tooth Free gingival groove from the attached gingiva

Free gingiva

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/18_tns.html

Free gingiva

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/18_tns.html

Free gingival - oral Surface

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/18_tns.html

Attached gingiva

Surface

Stippled
Free gingival groove from the free gingiva Mucogingival junction from alveolar mucosa

Separated by:

No submucosa Periosteum/ bone

Junctional epithelium

Functions

Floor of gingival sulcus Attachment Protection Fewer desmosomes High rate of turnover High metabolic activity Stratum Germinativum cells: hemidesmosomes

Different cells

Junctional epithelium

http://www.usc.edu/hsc/dental/ohisto/Cards/muc/18_tns.html

Interdental papilla and col

Interdental papilla

Facial or lingual parts of gingiva between teeth

Epithelium of the interproximal gingival tissue connecting facial and lingual interdental papillae Thin Nonkeratinized Concave in shape

Col

Hard palate
http://www1.us.elsevierhealth.com/SIMON/Bird/modern/EIC/graphics/7627_17_14.jpg

Epithelium

Keratinized
Dense under rugue Fatty cells in anterior lateral area Mucous glands in the posterior lateral area Absent in the midline under median raphe

Lamina Propria

Submucosa

Periosteum

Rugae

Epithelial folds

Function

Mastication Phonation Bundles of collagen fibers in LP origin: bony palate Insertion: papillary fibers of LP Function: anchorage
www.forsyth.org/oralpathology/ case_008b.htm

Traction Bands

Palatal mucosa

Specialized gustatory mucosa

Location

Dorsum of the tongue Filiform Fungiform Circumvallate Foliate

4 types of papillae

Filiform and fungiform papillae

Filiform papillae

Anterior 2/3s of the dorsum of the tongue Central cores of lamina propria covered by Ortho or parakeratinized epithelium No taste buds
Mushroom-shaped Vascular core of lamina propria covered by keratinized or nonkeratinized epithelium Taste buds may be found on the surface
www.forsyth.org/oralpathology/ case_086b.htm

Fungiform papillae

Filiform & fungiform papillae

Circumvallate papillae

Located in the posterior region of anterior 2/3 just in front of sulcus terminalis Large & rounded Surrounded by a trench-like feature Do not project over the surface Covered by non-keratinized epithelium Taste buds found on the internal wall of the trench Associated with Von Ebner glands

www.forsyth.org/oralpathology/ case_011.htm

Serous minor salivary glands Empty at the floor of the trench

Von Ebners Glands (serous glands)

Foliate papillae

At the side of posterior 1/3 of the tongue One or two longitudinal clefts Tastes buds found within the non-keratinized parts

http://www.forsyth.org/oralpathology/case_010.htm

Foliate papillae

http://education.vetmed.vt.edu/Curriculum/VM8054/Labs/Lab17/Images/digl10.jpg

Papillae of the Tongue

Papillae of the tongue Number Location shape Taste buds Keratinized Serous glands Innervation of taste cells
no

Function

Filiform Papillae Fungiform Papillae Circumvallate Papillae

majority

anterior 2/3 of the dorsum of the tongue

slender threadlike 2-3 mm long

no taste buds

yes

no

few, more numerous near the tip of the tongue 10-14

Foliate Papillae

4-11

interspersed between filiform in the anterior 2/3 Just anterior to the Vshaped sulcus between the body and the base of the tongue Lateral posterior part of the tongue

mushroom shaped

on the superior surface

no

no

Chorda tympani

give the rough masticatory surface of the tongue taste

large 3mm in diameter with a surrounding trench

on the walls

yes

Von Ebners glands

Glossopharyngeal nerve

taste

vertical gooves or furrows

on the walls

yes

yes

Glossopahryngeal nerve

taste

Taste buds

Barrel-shaped organs in epithelium Neuroepithelial vs. epithelial cells associated with sensory nerve endings Chemical response Rapid turnover/ 10 days

Taste buds

Location

Tongue

associated with the papillae

Soft Palate Pharynx Epiglottis Larynx

Taste Buds

Taste Pore Cell types (10-14/bud)

Supporting Cells (sustentacular cells) Taste Cells

Type 1(dark) Type 2 (light) Type 3 Type 4 Precursors

Basal cells

Taste buds

Taste buds

Taste buds

Taste sensations

4 types

Sweet Salt Sour Bitter

Regional Sensitivity Role of

Oder/olfaction Temperature

Innervations of taste Buds

Chorda tympani of facial nerve

Fungiform papillae
Vallate and foliate papillae soft palate pharynx Epiglottis Larynx

Glossopharyngeal nerve

Vagus nerve

Innervations of lingual taste buds

www.biology.eku.edu/RITCHISO/ tastebud.html

Nerves and blood vessels

Submucosa

Primary plexus of larger vessels and nerves

Secondary plexus of terminal nerve endings and capillary loops Encapsulated touch and temperature endings Axons associated with Merkels cells

Lamina Propria (dermal papillae)

Nerves and Blood Vessels

Epithelium

Avascular Free endings associated with pain

online-media.uni-marburg.de/ .../HIS/txt/skin/skin02.htm

ORAL MUCOSA Lip Soft Palate Cheek Vent. Surf /Tongue

Keratinized Epi.
skin and vermilion surfaces no no no

Minor Saliv. Glands

mucosal surface/LP (seromucous) (mucous) (seromucous) no yes + SL salivary gland seromucous

Fat Cells
no

Muscle
yes

Taste Buds
no

Fordyces spots
angles of the mouth yes yes no no no

Periosteum
no

no yes no yes no

yes yes yes no yes

yes no no no no

no no no no yes attached gingiva yes

Floor of no the Mouth Alveolar Mucosa Gingiva Hard Palate Dorsum of the tongue (ant. 2/3)
no yes except for sulcular / junctional yes yes except over Fungiform papillae

no posterior lateral No except for Von Ebners glands

no anterior lateral no

no

no

no

no

no all papillae except Filiform

no

yes

no

no