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ORAL ANATOMY &

PHYSIOLOGY
Oral Cavity (Mouth)

Extends from the lips to the


oropharyngeal isthmus
The oropharyngeal isthmus:
Is the junction of mouth
and pharynx.
Is bounded:
Above by the soft
palate and the
palatoglossal folds
Below by the dorsum
of the tongue

Subdivided into Vestibule & Oral cavity


proper
Vestibule

Slitlike space between the cheeks and the gums


Communicates with the exterior through the oral fissure
When the jaws are closed, communicates with the oral cavity proper behind
the 3rd molar tooth on each side
Superiorly and inferiorly limited by the reflection of mucous membrane
from lips and cheek onto the gums
Vestibule contd

The lateral wall of the vestibule is formed by the cheek


The cheek is composed of Buccinator muscle, covered laterally by the
skin & medially by the mucous membrane
A small papilla on the mucosa opposite the upper 2nd molar tooth marks the
opening of the duct of the parotid gland
Oral Cavity Proper

hard

soft palate

mylohyoid
It is the cavity within the alveolar margins of the maxillae and the mandible
Its Roof is formed by the hard palate anteriorly and the soft palate
posteriorly
Its Floor is formed by the mylohyoid muscle. The anterior 2/3rd of the tongue
lies on the floor.
Floor of the Mouth

Covered with mucous membrane


In the midline, a mucosal fold, the frenulum, connects the tongue to the
floor of the mouth
On each side of frenulum a small papilla has the opening of the duct of the
submandibular gland
A rounded ridge extending backward & laterally from the papilla is
produced by the sublingual gland
Nerve Supply

Sensory
Roof: by greater palatine and nasopalatine nerves (branches of maxillary nerve)
Floor: by lingual nerve (branch of mandibular nerve)
Cheek: by buccal nerve (branch of mandibular nerve)
Motor
Muscle in the cheek (buccinator) and the lip (orbicularis oris) are supplied by the
branches of the facial nerve
Tongue
Mass of striated muscles
covered with the mucous
membrane

Divided into right and left


halves by a median septum
- Three parts:
Oral (anterior )
Pharyngeal (posterior
)
Root (base)
- Two surfaces:
Dorsal
Ventral
Functions

The tonge is the most important articulator for speech production. During speech,
the tongue can make amazing range of movements

The primary function of the tongue is to provide a mechanism for taste. Taste
buds are located on different areas of the tongue, but are generally found around
the edges. They are sensitive to four main tastes: Bitter, Sour, Salty & Sweet

The tongue is needed for sucking, chewing, swallowing, eating, drinking,


sweeping the mouth for food debris and other particles and for making funny
faces (poking the tongue out, waggling it)

Trumpeters and horn & flute players have very well developed tongue muscles,
and are able to perform rapid, controlled movements or articulations
Dorsal Surface

Divided into anterior two


third and posterior one
third by a V-shaped
sulcus terminalis.

The apex of the sulcus


faces backward and is
marked by a pit called
the foramen cecum

Foramen cecum, an
embryological remnant,
marks the site of the
upper end of the
thyroglossal duct
Anterior two third: mucosa
is rough, shows three types
of papillae:
Filliform
Fungiform
Vallate

Posterior one third:


No papillae but shows
nodular surface because of
underlying lymphatic
nodules, the lingual tonsils
Ventral Surface
Smooth (no papillae)

In the midline anteriorly,


a mucosal fold, frenulum
connects the tongue with
the floor of the mouth

Lateral to frenulum, deep


lingual vein can be seen
through the mucosa

Lateral to lingual vein, a


fold of mucosa forms the
plica fimbriata
Muscles

The tongue is composed of two types of muscles:


Intrinsic
Extrinsic
Intrinsic Muscles

Confined to tongue
- No bony attachment
- Consist of:
Longitudinal
fibers
Transverse
fibers
Vertical fibers
Function: Alter the
shape of the tongue
Extrinsic Muscles

- Connect the tongue to the


surrounding structures: the
soft palate and the bones
(mandible, hyoid bone,
styloid process)
Include:
Palatoglossus
Genioglossus
Hyoglossus
Styloglossus

- Function: Help in
movements of the tongue
Movements

Protrusion: Genioglossus on both sides acting together


Retraction: Styloglossus and hyoglossus on both sides acting
together
Depression: Hyoglossus and genioglossus on both sides acting
together
Elevation: Styloglossus and palatoglossus on both sides acting
together
Sensory Nerve Supply

Anterior :
General sensations:
Lingual nerve
Special sensations :
chorda tympani
Posterior :
General & special
sensations:
glossopharyngeal
nerve
Base:
General & special
sensations: internal
laryngeal nerve
Motor Nerve Supply

Intrinsic muscles: Hypoglossal nerve

Extrinsic muscles: All supplied by the hypoglossal nerve, except the


palatoglossus . The palatoglossus supplied by the pharyngeal plexus
Blood Supply
Lingual Dorsal lingual
artery & vein
Arteries: artery & vein
Lingual artery
Tonsillar
branch of facial
artery
Ascending
pharyngeal
artery
Veins:
Lingual vein,
Deep lingual
ultimately Hypoglossal vein
drains into the nerve
internal jugular
vein
Lymphatic Drainage
Tip: Submental nodes
bilaterally & then deep
cervical nodes

Anterior two third:


Submandibular
unilaterally & then deep
cervical nodes

Posterior third:
Deep cervical nodes
(jugulodigastric mainly)
Clinical Notes

Pharyngeal
isthmus

Cleft palate :
Unilateral
Bilateral
Median
Paralysis of the soft palate
The pharyngeal isthmus can not be closed during swallowing and
speech
Palate
Lies in the roof of the oral
hard
cavity

Has two parts:


soft palate
Hard (bony) palate
anteriorly
Soft (muscular)
palate posteriorly
Hard Palate

Posteriorly, continuous
with soft palate

Its undersurface covered


by mucoperiosteum

Shows transverse ridges in


the anterior parts
Soft Palate
Attached to the posterior border
of the hard palate

Covered on its upper and lower


surfaces by mucous membrane

Composed of:
Muscle fibers
An aponeurosis
Lymphoid tissue
Glands
Blood vessels
Nerves
Muscles

Tensor veli palatini


Origin: spine of sphenoid; auditory
tube
Insertion: forms palatine
aponeurosis
Action: Tenses soft palate
Levator veli palatini
Origin:petrous temporal bone,
auditory tube, palatine aponeurosis
Insertion: palatine aponeurosis
Action: Raises soft palate
Musculus uvulae
Origin: posterior border of hard
palate
Insertion: mucosa of uvula
Action: Elevates uvula
Muscles
Palatoglossus
Origin: palatine aponeurosis
Insertion: side of tongue
Action: pulls root of tongue
upward, narrowing
oropharyngeal isthmus

Palatopharyngeus
Origin: palatine aponeurosis
Insertion: posterior border of
thyroid cartilage
Action: Elevates wall of the
pharynx
Sensory Nerve Supply

Mostly by the maxillary nerve


through its branches:
Greater palatine nerve
Lesser palatine nerve
Nasopalatine nerve

Glossopharyngeal nerve
supplies the region of the soft
palate
Motor Nerve Supply

All the muscles, except tensor veli palatini, are supplied by the:
Pharyngeal plexus

Tensor veli palatini supplied by the:


Nerve to medial pterygoid, a branch of the mandibular division of the
trigeminal nerve
Blood Supply
Branches of the maxillary
artery
Greater palatine
Lesser palatine
Sphenopalatine

Ascending palatine,
branch of the facial artery

Ascending pharyngeal,
branch of the external
carotid artery
DENTAL ANATOMY &
PHYSIOLOGY
Physiology, Etiology, Epidemiology,
Diagnosis, and Treatment

Reviewed by:
Dental Anatomy and Physiology

Definition (teeth): There are two definitions

Primary (deciduous)
Secondary (permanent)
Dental Anatomy and Physiology

Elements

A tooth is made up of three elements:

Water
Organic materials
Inorganic materials
Dental Anatomy and Physiology
Dentition (teeth): There are two dentitions

Primary (deciduous)
Consist of 20 teeth
Begin to form during the first
trimester of pregnancy
Typically begin erupting around 6
months
Most children have a complete
primary dentition by 3 years
of age

1. Oral Health for Children: Patient Education Insert. Compend Cont Educ Dent.
Dental Anatomy and Physiology
Dentition (teeth): There are two dentitions

Secondary (permanent)
Consist of 32 teeth in most cases
Begin to erupt around 6 years
of age
Most permanent teeth have
erupted by age 12
Third molars (wisdom teeth) are
the exception; often do not
appear until late teens or
early 20s
Dental Anatomy and Physiology
Identifying Teeth

Incisors function as cutting or shearing


instruments for food.
Canines possess the longest roots of all teeth and
are located at the corners of the dental arch.
Premolars act like the canines in the tearing of
food and are similar to molars in the grinding of
food.
Molars are located nearest the
temporomandibular joint (TMJ), which serves as
the fulcrum during function. Incisor Canine Premolar Molar
Dental Anatomy and Physiology

Enamel
The Dental Tissues: Dentin

Enamel (hard tissue)


Dentin (hard tissue) Odontoblast Layer Gingiva
Odontoblast Layer
Pulp Chamber (soft tissue)
Periodontal Ligament
Gingiva (soft tissue)
Periodontal Ligament (soft tissue) Pulp
Chamber
Cementum (hard tissue)
Cementum
Alveolar Bone (hard tissue)
Pulp Canals Alveolar Bone
Apical Foramen
Apical Foramen

Pulp Canals
Dental Anatomy and Physiology

Anatomic Crown
The anatomic crown is the
portion of the tooth covered by
enamel.
The anatomic root is the lower
two thirds of a tooth.
The pulp chamber houses the
dental pulp, an organ of Pulp
Chamber
myelinated and unmyelinated
nerves, arteries, veins, lymph
channels, connective tissue cells,
and various other cells.
Anatomic Root
Dental Anatomy and Physiology

Enamel

The 4 main dental tissues: Dental Pulp


Dentin
Enamel
Dentin
Cementum
Dental Pulp

Cementum
Dental Anatomy
and Physiology
Dentin

Dental TissuesDentin (Tubules)2 Pulp

Dentinal tubules connect the dentin and the


pulp (innermost part of the tooth,
circumscribed by the dentin and lined with a
layer of odontoblast cells)
The tubules run parallel to each other in an S-
shape course
Tubules contain fluid and nerve fibers Tubule
External stimuli cause movement of the
dentinal fluid, a hydrodynamic movement,
which can result in short, sharp pain episodes Fluid Nerve Fibers

Odontoblast
Cell
Dental Anatomy
and Physiology
Dental TissuesDentin (Tubules)2
Presence of tubules renders dentin
permeable to fluoride
Number of tubules per unit area varies
depending on the location because of
the decreasing area of the dentin
surfaces in the pulpal direction
Dental Anatomy Enamel

and Physiology
Dental TissuesDentin (Tubules)2

Association between erosion and Tubules


dentin hypersensitivity3
Open/patent tubules
Greater in number
Larger in diameter
Exposed
Removal of smear layer Dentin
Erosion/tooth wear
Receding
Gingiva

Odontoblast
Dental Anatomy and Physiology

Oral Cavity/Environment7,8

Plaque
Saliva
pH Values
Demineralization
Remineralization
Dental Anatomy
and Physiology
Oral Cavity

Plaque:7,8
is a biofilm
contains more than 600 different
identified species of bacteria
there is harmless and harmful plaque
salivary pellicle allows the bacteria to
adhere to the tooth surface, which
begins the formation of plaque
Dental Anatomy
and Physiology
Oral Cavity
Saliva:7,8
complex mixture of fluids
performs protective functions:
lubricationaids swallowing
mastication
key role in remineralization of
enamel and dentin
buffering
Dental Anatomy
and Physiology
Oral Cavity
pH values:7,8
measure of acidity or alkalinity of a
solution
measured on a scale of 1-14
pH of 7 indicated that the solution is
neutral
pH of the mouth is close to neutral
until other factors are introduced
pH is a factor in demineralization
and remineralization

3. Strassler HE, Drisko CL, Alexander DC.


Dental Anatomy
and Physiology
Oral Cavity

Demineralization:7,8
mineral salts dissolve into the
surrounding salivary fluid:
enamel at approximate pH of
5.5 or lower
dentin at approximate pH of 6.5
or lower
erosion or caries can occur
Dental Anatomy
and Physiology
Oral Cavity

Remineralization:7,8
pH comes back to neutral (7)
saliva-rich calcium and phosphates
minerals penetrate the damaged
enamel surface and repair it:
enamel pH is above 5.5
dentin pH is above 6.5