KULIAH

KULIAH
ILMU PENYAKIT
ILMU PENYAKIT
MULUT 1
MULUT 1
Kus Harijanti, drg.MKes.SpPM
Kus Harijanti, drg.MKes.SpPM
11 Maret 201
11 Maret 201

T!PIK "
T!PIK "

SISTEM PE#TAHANAN
SISTEM PE#TAHANAN
MUK!SA #!N$$A MULUT
MUK!SA #!N$$A MULUT
Mu%&sa 'u(ut se)ara %(inis
Mu%&sa 'u(ut se)ara %(inis
1. 1.
Masti)at&r* 'u)&sa " epite( +er%eratin,
Masti)at&r* 'u)&sa " epite( +er%eratin,
(a'ina pr&pia padat, teri%at erat pada
(a'ina pr&pia padat, teri%at erat pada
tu(ang
tu(ang

e,.gingi-a, pa(atu'
e,.gingi-a, pa(atu'
2. 2.
Spe)ia(i.ed 'u)&sa " epite( +er%eratin,
Spe)ia(i.ed 'u)&sa " epite( +er%eratin,
(a'ina pr&pia padat / tipis, teri%at pada
(a'ina pr&pia padat / tipis, teri%at pada
'us%u(us di+a0a1n*a
'us%u(us di+a0a1n*a

e,. 2&rsu'
e,. 2&rsu'
(ida1, -er'i((i&n +&rder
(ida1, -er'i((i&n +&rder
.Lining 'u)&sa " epite( te+a(, td%3sd%t
.Lining 'u)&sa " epite( te+a(, td%3sd%t
%eratin, (a'.pr&pia tipis / e(astis,
%eratin, (a'.pr&pia tipis / e(astis,
su+'u%&sa teri%at pd 'us)(e
su+'u%&sa teri%at pd 'us)(e

sering
sering
+ergera% / sering ter%ena trau'a.
+ergera% / sering ter%ena trau'a.
E,. Mu%&sa +i+ir, 'u%&sa pipi, pa(atu'
E,. Mu%&sa +i+ir, 'u%&sa pipi, pa(atu'
(una%, -esti+u(u' &ris, dasar 'u(ut.
(una%, -esti+u(u' &ris, dasar 'u(ut.
SISTEM PE#TAHANAN MUK!SA
SISTEM PE#TAHANAN MUK!SA
MUK!SA #!N$$A MULUT
MUK!SA #!N$$A MULUT
I. Mu%&sa 'u(ut
I. Mu%&sa 'u(ut
II. Sa(i-a
II. Sa(i-a
III.4airan su(%us gingi-a
III.4airan su(%us gingi-a
I5. Ke(enjar (i'6e regi&na(
I5. Ke(enjar (i'6e regi&na(
I. Mu%&sa 'u(ut
I. Mu%&sa 'u(ut
Mu%&sa 'u(ut terdiri dari
Mu%&sa 'u(ut terdiri dari
71ist&(&gis8"
71ist&(&gis8"
1.
1.
Epite(
Epite(
2.
2.
La'ina pr&pria
La'ina pr&pria
.
.
Su+'u%&sa
Su+'u%&sa

Se( epite( sa(ing +eri%atan erat satu dg

Se( epite( sa(ing +eri%atan erat satu dg
*ang (ain, 1a'pir tida% ada
*ang (ain, 1a'pir tida% ada
intercllular
intercllular
space
space
dan 1an*a ada sd%t
dan 1an*a ada sd%t
intercellular
intercellular
substance.
substance.

9aringan epite( dipisa1%an dg jaringan

9aringan epite( dipisa1%an dg jaringan
di+01n*a &(e1 (apisan tipis *g dis+t
di+01n*a &(e1 (apisan tipis *g dis+t
basemen membrane(lamina basalis).
basemen membrane(lamina basalis).

Tipe jar epite(

Tipe jar epite(

si'p(e epit1e(iu'
si'p(e epit1e(iu'

strati6ied epit1e(iu'
strati6ied epit1e(iu'
:ungsi epite( "
:ungsi epite( "

Pr&te%si
Pr&te%si

%u(it, 'u%&sa &ra(

%u(it, 'u%&sa &ra(

Sensasi
Sensasi

(ida1
(ida1

Se%resi
Se%resi

du%tus
du%tus

A+s&r+si
A+s&r+si

usus 1a(us
usus 1a(us

2i6usi
2i6usi

paru;paru
paru;paru
I.1.Epite( 'u%&sa 'u(ut
I.1.Epite( 'u%&sa 'u(ut
1.
1.
Stratu' +asa(is 7 +asa( )e(( (a*er8
Stratu' +asa(is 7 +asa( )e(( (a*er8
2.
2.
Stratu' spin&su'
Stratu' spin&su'
.
.
Strat. $ranu(&su'7Pri)%(e )e(( (a*er8
Strat. $ranu(&su'7Pri)%(e )e(( (a*er8
<.
<.
Strat. (u)idu' 7Inter'ediate (a*er8
Strat. (u)idu' 7Inter'ediate (a*er8
=.
=.
Stratu' %&rneu'7Keratini.ed (a*er8
Stratu' %&rneu'7Keratini.ed (a*er8
I.1.1.Stratu' +asa(is
I.1.1.Stratu' +asa(is
7>asa( )e(( (a*er8
7>asa( )e(( (a*er8

Me(e%at pada 'e'+rana +asa(is

Me(e%at pada 'e'+rana +asa(is

Se( +er+entu% si(indris

Se( +er+entu% si(indris

dis+t
dis+t
juga stratu' si(indri%u'
juga stratu' si(indri%u'

Me'pun*ai inti
Me'pun*ai inti

Se( 'enga(a'i 'it&sis

Se( 'enga(a'i 'it&sis

'engganti se( *g 'ati3rusa%,
'engganti se( *g 'ati3rusa%,
'a%a dis+t juga s+g stratu'
'a%a dis+t juga s+g stratu'
ger'inati-u'
ger'inati-u'
I.1.2.Stratu' spin&su'
I.1.2.Stratu' spin&su'
7Pri)%(e )e(( (a*er8
7Pri)%(e )e(( (a*er8

Me(e%at pada se( +asa(

Me(e%at pada se( +asa(

Se( +er+entu% p&(i1idra(

Se( +er+entu% p&(i1idra(

Se( 'e'pun*ai inti

Se( 'e'pun*ai inti

Ter(i1at +erduri 7spin*8

Ter(i1at +erduri 7spin*8

dise+ut
dise+ut
stratu' spin&su'
stratu' spin&su'
I.1..Stratu' $ranu(&su'
I.1..Stratu' $ranu(&su'

Se( +er+entu% pipi1 dan pa(ing +esar

Se( +er+entu% pipi1 dan pa(ing +esar

2a(a' sit&p(as'a 'engandung granu(a

2a(a' sit&p(as'a 'engandung granu(a

Se( 'e'pun*ai nu)(eus

Se( 'e'pun*ai nu)(eus

Pd stratu' 1,2, se( 'e'pun*ai nu)(eus,

Pd stratu' 1,2, se( 'e'pun*ai nu)(eus,
'a%in %eper'u%an sit&p(as'a se'a%in
'a%in %eper'u%an sit&p(as'a se'a%in
+esar dan nu)(eus se'a%in %e)i(, sa'pai
+esar dan nu)(eus se'a%in %e)i(, sa'pai
pada stratu' %&rneu' nu)(eus 1i(ang.
pada stratu' %&rneu' nu)(eus 1i(ang.
I.1.<.Stratu' (u)idu'
I.1.<.Stratu' (u)idu'
Inter'ediate (a*er
Inter'ediate (a*er

Se( +er+entu% pipi1

Se( +er+entu% pipi1

Pada 'u%&sa +er%eratin 7sd%t3+an*a%8

Pada 'u%&sa +er%eratin 7sd%t3+an*a%8

stratu' ini tida% dapat di(i1at
stratu' ini tida% dapat di(i1at

Pd 'u%&sa tida% +er%eratin

Pd 'u%&sa tida% +er%eratin

dapat di(i1at
dapat di(i1at
dengan je(as
dengan je(as

Nu)(eus %e)i(
Nu)(eus %e)i(
I.1.=.Stratun %&rneu'
I.1.=.Stratun %&rneu'
7Keratini.ed (a*er8
7Keratini.ed (a*er8

Se( pipi1, 1e%sag&na(, tanpa inti3&rgane(

Se( pipi1, 1e%sag&na(, tanpa inti3&rgane(

Ter(eta% pa(ing per'u%aan

Ter(eta% pa(ing per'u%aan

dapat di(i1at
dapat di(i1at
se)ara %(inis
se)ara %(inis

Muda1 'enga(a'i des%0a'asi

Muda1 'enga(a'i des%0a'asi
7'enge(upas8, 'isa( %rn 'a%anan
7'enge(upas8, 'isa( %rn 'a%anan

Le+i1 tipis dp (apisan %&rneu' %u(it

Le+i1 tipis dp (apisan %&rneu' %u(it
Me'+rana +asa(is
Me'+rana +asa(is

Merupa%an +atas antara epite( dan (a'ina

Merupa%an +atas antara epite( dan (a'ina
pr&pria
pr&pria

Te'pat 'e(e%atn*a stratu' +asa(is

Te'pat 'e(e%atn*a stratu' +asa(is

Ter(i1at +erge(&'+ang
Ter(i1at +erge(&'+ang

dise+ut rete;
dise+ut rete;
ridge3rete pegs
ridge3rete pegs

Merupa%an +arrier (a*er

Merupa%an +arrier (a*er
I.2.La'ina Pr&pria
I.2.La'ina Pr&pria

Merupa%an
Merupa%an
loose connective tissue
loose connective tissue
*g
*g
ter(eta%
ter(eta%
di+a0a1 epite(
di+a0a1 epite(

Mu%&sa 7'u)&us 'e'+rane8 ada(a1

Mu%&sa 7'u)&us 'e'+rane8 ada(a1
%&'+inasi dari epite( dan (a'ina pr&pria
%&'+inasi dari epite( dan (a'ina pr&pria

2ida(a'n*a terdapat se( i'un 7*g pa(ing

2ida(a'n*a terdapat se( i'un 7*g pa(ing
+an*a% ada(a1 >;)e(( *g 'ense%resi IgA8.
+an*a% ada(a1 >;)e(( *g 'ense%resi IgA8.
2ida(a'n*a terdapat
2ida(a'n*a terdapat

Colagen
Colagen

'enentu%an sta+i(itas,
'enentu%an sta+i(itas,
'e'pert1n%an +entu% /e%stensi+i(itas jar.
'e'pert1n%an +entu% /e%stensi+i(itas jar.

Elastin
Elastin

'e'perta1an%an +entu%
'e'perta1an%an +entu%

Retikulin
Retikulin

*ang 'engi%at
*ang 'engi%at
colagen
colagen

Siste' ini +erada d('

Siste' ini +erada d('
extra cellular matrix
extra cellular matrix

*ang terdr dr )ar+&1idrat;pr&tein )&'p(e,
*ang terdr dr )ar+&1idrat;pr&tein )&'p(e,

2ida(a'n*a juga terdapat se( *aitu"

2ida(a'n*a juga terdapat se( *aitu"
6i+r&+(ast, *ang 'e;se%resi sera+ut
6i+r&+(ast, *ang 'e;se%resi sera+ut
/ 'atri%s
/ 'atri%s

Se( p(as'a
Se( p(as'a

Histi&sit
Histi&sit

Mast&sit
Mast&sit

Ma%r&6ag
Ma%r&6ag
La'ina pr&pria ter+agi "
La'ina pr&pria ter+agi "

Papi((ar* (a*er
Papi((ar* (a*er

+ag atas 'e(e%at pd

+ag atas 'e(e%at pd
'e'+rana +asa(is, +ag +a0a1 'e(e%at pd
'e'+rana +asa(is, +ag +a0a1 'e(e%at pd
reti)u((ar* (a*er. Mengandung sera+ut
reti)u((ar* (a*er. Mengandung sera+ut
%&(agen 1a(us *g tersusun se+agai
%&(agen 1a(us *g tersusun se+agai
jaringan i%at %end&r
jaringan i%at %end&r

#eti)u(((ar* (a*er
#eti)u(((ar* (a*er

+ag +a0a1 dr ret.(a*er

+ag +a0a1 dr ret.(a*er
ada(a1 su+'u%&sa. Mengandung sera+ut
ada(a1 su+'u%&sa. Mengandung sera+ut
%&(agen *g (e+i1 %asar / (e+i1 padat.
%&(agen *g (e+i1 %asar / (e+i1 padat.
Pada (a'ina pr&pria terdapat "
Pada (a'ina pr&pria terdapat "

Siste' s*ara6, ujung s*ara6 sens&ri

Siste' s*ara6, ujung s*ara6 sens&ri
'asu% %e epite(
'asu% %e epite(

Siste' -as%u(er
Siste' -as%u(er

Siste' (i'6ati%
Siste' (i'6ati%
I.1..Su+'u%&sa
I.1..Su+'u%&sa

Ter(eta% di+a0a1 (a'ina pr&pia

Ter(eta% di+a0a1 (a'ina pr&pia

Su+'u%&sa dapat 'e(e%at pd tu(ang

Su+'u%&sa dapat 'e(e%at pd tu(ang
atau 'us%u(us
atau 'us%u(us

Pada su+'u%&sa 7atau ret.(a*er8

Pada su+'u%&sa 7atau ret.(a*er8
terdapat %e(enjar se+asea dan
terdapat %e(enjar se+asea dan
%e(enjar (iur.
%e(enjar (iur.
II. Sa(i-a
II. Sa(i-a

Sa(i-ar* g(and
Sa(i-ar* g(and

:ungsi sa(i-a
:ungsi sa(i-a

K&'p&nen sa(i-a
K&'p&nen sa(i-a

Ke)epatan a(iran sa(i-a

Ke)epatan a(iran sa(i-a
Sa(i-a ada(a1 "
Sa(i-a ada(a1 "

4airan *ang +erada da(a' r&ngga 'u(ut

4airan *ang +erada da(a' r&ngga 'u(ut

2i1asi(%an &(e1
2i1asi(%an &(e1
salivary gland
salivary gland

9erni1, aga% +er+ui1, aga% %enta(

9erni1, aga% +er+ui1, aga% %enta(

? @=A terdiri dari air

? @=A terdiri dari air

Whole saliva
Whole saliva
" sa(i-a, )airan )re-i)u(er
" sa(i-a, )airan )re-i)u(er
gingi-a, sisa 'a%anan, se( epite( *ang
gingi-a, sisa 'a%anan, se( epite( *ang
(epas, se%resi +r&n%1us, 'i%r&&rganis'e
(epas, se%resi +r&n%1us, 'i%r&&rganis'e
dan pr&du%n*a.
dan pr&du%n*a.
II.1. Sa(i-ar* g(and
II.1. Sa(i-ar* g(and

Merupa%an %e(. E%s&%reen 7'e'pun*ai

Merupa%an %e(. E%s&%reen 7'e'pun*ai
du%tus untu% 'enge(uar%an pr&du%n*a
du%tus untu% 'enge(uar%an pr&du%n*a
%eda(a' r&ngga 'u(ut8
%eda(a' r&ngga 'u(ut8

Terdiri " Ma*&r S.g dan Min&r S.g.

Terdiri " Ma*&r S.g dan Min&r S.g.

Ada tipe se( " ser&us 7)air8, 'u%&us

Ada tipe se( " ser&us 7)air8, 'u%&us
7%enta(8 dan ser&'u%&us 7aga% %enta(8
7%enta(8 dan ser&'u%&us 7aga% %enta(8
Par&tis g(and
Par&tis g(and

Pa(ing +esar, sa(i-a +ersi6at

Pa(ing +esar, sa(i-a +ersi6at
ser&us, %andungan pr&tein B
ser&us, %andungan pr&tein B

Mengandung pt*a(in 7en.i' untu%

Mengandung pt*a(in 7en.i' untu%
'eng1idr&(isis %ar+&1idrat8
'eng1idr&(isis %ar+&1idrat8

2u%tusn*a dise+ut stensen

2u%tusn*a dise+ut stensen
Su+'andi+u(aris g(and "
Su+'andi+u(aris g(and "

U%uran sedang
U%uran sedang

Sa(i-a +ersi6at ser&'u%&us

Sa(i-a +ersi6at ser&'u%&us

2u%tusn*a dise+ut C1art&n

2u%tusn*a dise+ut C1art&n
Su+(ingua(is g(and "
Su+(ingua(is g(and "

U%uran pa(ing %e)i(

U%uran pa(ing %e)i(

4airan +ersi6at 'u%&us

4airan +ersi6at 'u%&us

Kandungan pr&tein sedi%it

Kandungan pr&tein sedi%it
Min&r sa(i-ar* g(and "
Min&r sa(i-ar* g(and "

Terse+ar di su+'u%&sa, terdiri <=0;

Terse+ar di su+'u%&sa, terdiri <=0;
D=0 du%tus
D=0 du%tus

Pada pa(atu' +ersi6at 'u%&us

Pada pa(atu' +ersi6at 'u%&us

Pada (ida1,+i+ir,pipi +ersi6at

Pada (ida1,+i+ir,pipi +ersi6at
ser&'u%&us
ser&'u%&us
II.2. :ungsi sa(i-a
II.2. :ungsi sa(i-a

Lu+ri)ati&n
Lu+ri)ati&n

Anti'i)r&+ia(
Anti'i)r&+ia(

#e'inera(i.ati&n
#e'inera(i.ati&n

4(eansing
4(eansing

>u66ering
>u66ering

2igesti-e
2igesti-e

Mu)&sa( integrit*
Mu)&sa( integrit*
II..K&'p&nen sa(i-a
II..K&'p&nen sa(i-a

L
L

'u)in,pr&(ine;ri)1 pr&t, H2!

'u)in,pr&(ine;ri)1 pr&t, H2!

A
A

(a)t&6erin,(*s&.*'e, (a)t&per&,*dase,
(a)t&6erin,(*s&.*'e, (a)t&per&,*dase,
sIgA, 'u)in, 1istatin, )*statin, pr&(ine r p
sIgA, 'u)in, 1istatin, )*statin, pr&(ine r p

#
#

4a, staterin, ani&ni), pr&(ine r p

4a, staterin, ani&ni), pr&(ine r p

4
4

H
H
2 2
!
!

>
>

H4!
H4!

dan P!
dan P!
<EEEE <EEEE
II.. Ke)epatan a(iran sa(i-a
II.. Ke)epatan a(iran sa(i-a

Pd saat istira1at 0,<'(3'n

Pd saat istira1at 0,<'(3'n

T&ta( per1ari ?F00;D00'(

T&ta( per1ari ?F00;D00'(

#esting 6(&0 rate dipengaru1i &(e1"

#esting 6(&0 rate dipengaru1i &(e1"
1. 1.
U'ur
U'ur

'a%in tua '%n sedi%it

'a%in tua '%n sedi%it
2. 2.
4ir)adian r*t1
4ir)adian r*t1

pagi G siang
pagi G siang
. .
P&sisi tu+u1
P&sisi tu+u1

+erdiri B
+erdiri B
<. <.
Sinar
Sinar

'enurun saat ge(ap

'enurun saat ge(ap
=. =.
Ma%anan3rangsangan +au2an
Ma%anan3rangsangan +au2an
III. 4airan su(%us gingi-a
III. 4airan su(%us gingi-a

Merupa%an %&'p&nen dara1 *g 'en)apai

Merupa%an %&'p&nen dara1 *g 'en)apai
per'u%aan 'u%&sa 'e(a(ui
per'u%aan 'u%&sa 'e(a(ui
junctional
junctional
epithelium.
epithelium.

Terdiri dari Ig, a(+u'in, trans6erin,

Terdiri dari Ig, a(+u'in, trans6erin,
g(i%&pr&tein, (ip&pr&tein, 1apt&g(&+in,
g(i%&pr&tein, (ip&pr&tein, 1apt&g(&+in,
neutr&6i(, '&n&sit, (i'6&sit.
neutr&6i(, '&n&sit, (i'6&sit.
I5. Ke(enjar (i'6e regi&na(
I5. Ke(enjar (i'6e regi&na(
7se)&nd3perip1era( (*'p1&id
7se)&nd3perip1era( (*'p1&id
&rgans8
&rgans8

Sp(een,(*'p1 n&des, t&nsi(

Sp(een,(*'p1 n&des, t&nsi(

:ungsi 'e'a%si'a(%an se( i'un d('

:ungsi 'e'a%si'a(%an se( i'un d('
'e(a0an su+stansi asing
'e(a0an su+stansi asing

Yang 'e(a*ani 'u(ut "

Yang 'e(a*ani 'u(ut "
1. 1.
T&nsi(
T&nsi(
2. 2.
L*'p1 n&des pd %e(.sa(i-a dan gingi-a,
L*'p1 n&des pd %e(.sa(i-a dan gingi-a,
dan se( i'un *g terse+ar pd su+'u%&sa
dan se( i'un *g terse+ar pd su+'u%&sa
Lymphoid Tissues
Lymphoid Tissues
Origins of B and T cells
Origins of B and T cells
Lida1
Lida1
terdpt < 'a)a' papi(a "
terdpt < 'a)a' papi(a "

Papi(a :i(i6&r'is
Papi(a :i(i6&r'is
H Terdpt pd d&rsu' (ida1
H Terdpt pd d&rsu' (ida1
H Tersusun sejajar su(%us ter'ina(is
H Tersusun sejajar su(%us ter'ina(is
H Muda1 putus
H Muda1 putus

'uda1 regenerasi
'uda1 regenerasi
H #un)ing tinggi 2;'', tipis spt ra'+ut
H #un)ing tinggi 2;'', tipis spt ra'+ut

Papi(a :ungi6&r'is
Papi(a :ungi6&r'is
H Terse+ar diantara P.:i(i6&r'is, %eara1
H Terse+ar diantara P.:i(i6&r'is, %eara1
ujung (ida1 'a%in +an*a%
ujung (ida1 'a%in +an*a%
H Spt ja'ur
H Spt ja'ur
H Spt ja'ur 7tang%ai pende%,atas (e+ar8
H Spt ja'ur 7tang%ai pende%,atas (e+ar8
H Kun)up %e)ap terdpt pd epite(
H Kun)up %e)ap terdpt pd epite(

Papi(a :&(iata
Papi(a :&(iata
H sa'ping n +e(a%ang
H sa'ping n +e(a%ang
H +entu% (ipatan 'irip daun
H +entu% (ipatan 'irip daun
H terdpt %e(enj (iur 'in&r ; ser&us
H terdpt %e(enj (iur 'in&r ; ser&us

Papi(a Sir%u' 5a(ata

Papi(a Sir%u' 5a(ata
H (eta% spanjang su(%us ter'ina(is
H (eta% spanjang su(%us ter'ina(is
H j'( pd 'anusia 10;1<
H j'( pd 'anusia 10;1<
H trdpt %e( (iur *g +er'uara pd dsr a(ur;
H trdpt %e( (iur *g +er'uara pd dsr a(ur;
ser&us
ser&us

Kun)up %e)ap
Kun)up %e)ap
H'engandung resept&r untu%
H'engandung resept&r untu%
taste.
taste.
*kuncup kecap
*kuncup kecap
terut pd papi(a (ida1, jg
terut pd papi(a (ida1, jg
terdpt pd pa(atu' dan epig(&tis
terdpt pd pa(atu' dan epig(&tis

#asa %e)ap dasar"

#asa %e)ap dasar"
H'anis / asin pd ujung (ida1 7Papi(a
H'anis / asin pd ujung (ida1 7Papi(a
6ungi6&r'is8
6ungi6&r'is8
Hasa' pd sa'ping (ida1 7Papi(a 6&(iata8
Hasa' pd sa'ping (ida1 7Papi(a 6&(iata8
Hpa1it pd Papi(a sir%u' -a(ata
Hpa1it pd Papi(a sir%u' -a(ata
LI2AH
LI2AH
LI2AH
LI2AH