The inner surface has thick stratified squamous epithelium. 4 Inside is a thick stratified squamous epithelium, with mucous glands in its lamina propria. In a subsequent chapter, we cover the special lineage of the junctional epithelium that gives the adult tissue its uniqueness. Figure 3.12: Illustration of the histology of the soft palate. The hard palate is lined by an ortho-keratinized stratified squamous epithelium and mostly lacks a sub-mucosa, making for a rigid connection to underlying bone tissue. Connective tissue grafts are relatively common in dentistry and maxillofacial surgery, but these technologies are starting to generate changes in tissue grafting below the neck, too. Large dermal papillae and rete pegs create the stippled (rough surface) appearance of the attached gingiva. Image credit: “Smoker’s melanosis in oral mucosa with brown black pigmentation” by Skinstudy is licensed under CC BY SA 3.0. The skin and the oral mucosa share a lot in common because of their shared lineage from ectoderm and mesoderm. Levels of keratinization are categorized into three or four groups listed in Table 3.3. Carotene is an orange pigment molecule made by plants which accumulates in the epidermis. The amount and type of melanin produced has a baseline rate set at birth—this is not regulated by genes we inherit from our parents, but by more complex epigenetic factors. Other epithelia attach to connective tissue only on their basolateral surface, their apical surface faces the external environment. It has a rich blood supply and numerous elastic fibers within the lamina propria, but few dermal papillae and rete pegs. Figure 3.30: Gingival hyperplasia. Sulcular epithelium (or crevicular epithelium) is lined by either a non-keratinized or para-keratinized stratified squamous epithelium. Circumvallate papillae are found at the border between the anterior and posterior portion of the tongue, the sulcus terminalis. By Roger Shore at the School of Dentistry, University of Leeds. Figure 3.25: Nicotinic stomatitis, an example of hyper-keratosis. The underlying cause of the pseudopocket may need to be addressed. They may discharge directly to the surface of the skin, but are mostly associated with hair follicles. Histology Learning System [ Digestive System: Oral Cavity and Teeth, lip, vermilion border] Furthermore, the concept that pink is healthy and brown is unhealthy is not shared across cultures. Vermilion border and skin specimens of cattle, rats and humans were processed under standardized conditions for light microscopic observation. The thinness of the epithelium, coupled with the rich blood supply in the deeper lamina propria are also why some medications are given sub-lingually. Surgeries and treatments to remove gingival pigment exist, often advertising what is found in textbooks: healthy gingiva should be pinkish or whitish in color (try a google search for gingival hyperpigmentation if you are skeptical). Junctional epithelium is thinner than other gingival mucosa, only five cells thick at the end. These papillae function for providing friction only, their mucosa contain no taste buds. These long fibrous proteins accumulate within keratinocytes, the principle cell of a stratified squamous epithelium. Figure 3.4: Histology of the vermilion border using Azan stain, at the border between the oral mucosa (left side) and the red zone of the lip (right side). Mucograft – acquired by Geistlich biomaterials, Table 3.5: Further reading about currently available dental biomaterials. This procedure is very similar to different types of bone tissue grafts and is not limited in use to the gingiva—a video of a heart valve replacement using bovine pericardium can be viewed here We hope you appreciate the amount of histology and cell biology required to understand how pieces of cow hearts can be used to repair damaged gingiva. Inflammation of any tissue is referred to as tissue-name-itis, hence gingivitis is inflammation of the gingiva, while periodontitis is inflammation to the gingiva and periodontium. The epithelial cells of oral mucosa do not live long enough to easily acquire the multiple mutations to oncogenes and tumor-suppressor genes required to cause cancer. Because of the large blood supply and low levels of keratin, you may often hear healthy attached gingiva should appear pinkish, but this assumes the absence of melanin. It received that name for having finger-like dermal papillae on the apical surface, compared to the smoother transition between the papillary and the reticular layer. This gives them a more reddish or pinkish baseline appearance (see alveolar mucosa pigmentation below). Melanin can be deposited in gingival mucosa, either uniformly (evenly) or focally (localized, such as a freckle or macule– a freckle on the labia). These are regions more important for speech and swallowing. There are a few small differences. It may look similar to edema, but the underlying cause (and therefore treatment) is different. 3.9 illustrates a masticatory mucosa, whose apical surface contains a degree of keratinization. a) before, b) laser incisions, c) immediately after surgery, d) 2-week post-operative. Attached gingiva is a type of masticatory mucosa, lined with a para-keratinized stratified squamous epithelium. It is where lipstick is sometimes applied. The vermilion border (sometimes spelled vermillion border), also called margin or zone, is the normally sharp demarcation between the lip and the adjacent normal skin. The acellular tissue that remains should not trigger tissue rejection (collagen is collagen across vertebrates), but it acts as a scaffold. It contains more No. Image credit: Really bad gingivitis by D. Rosenbach, is licensed CC BY 3.0. It has no sebaceous glands, sweat glands, or facial hair.. Sagital Section Of Tongue 35. In subsequent chapters on the teeth, pay attention to how the lineage of tooth tissues is different from that of oral mucosa, as well as to how their basic pattern is similar. Figure 3.9: Lining mucosa (upper half) is non-keratinized, masticatory mucosa (lower half) is partially keratinized. There were no cervical lymph nodes. Some regions of the oral cavity won’t require such a strong connection, and the rete pegs and dermal papillae are smaller or absent. Figure 3.14: Example of healthy human gingival coloration. The amount of keratinization of the oral mucosa reflects the amount of stress or abrasion that region experiences. This allows the papillae to pick up more stains from tobacco smoke, foods, or oral bacteria, creating thicker, darker bumps on the tongue. Figure 3.4: Histology of the vermilion border using Azan stain, at the border between the oral mucosa (left side) and the red zone of the lip (right side). Unlike keratin, melanin is a pigment, meaning it absorbs only certain wavelengths of light (has a color). It includes edema in the ECM of connective tissues in the lamina propria and sub-mucosa, as well as inside the epithelial cells of the oral mucosa. In response to stress, epithelial cells express more keratin, causing an increase in the degree of keratinization. How is the epithelium of the oral mucosa different to that of the vermilion border? Enlargement of the gingival margin, whether by mitosis or fluid buildup, deepens the measurement of a pocket, but does not share the same harmful loss of the epithelial attachment. Sheldahl's histology, embryology, anatomy and physiology. In response to chronic stress, the ortho-keratinized epithelium produces more keratin, leading to a more white-ish appearance. Figure 3.31: Cosmetic surgery for gummy smile. Interdental gingiva is similar to the attached gingiva. CORE stratified skeletal muscles Orbicularis Oris SKIN Stratified Squamous epithelium, keratinized ORAL MUCOSA -Arrow shows labial salivary glands in the submucosa. Image credit: leukoplakia by dozenist is licensed CC BY 3.0. Environmental changes trigger melanocytes to changes the levels of melanin they produce, and these changes illustrate several functions of melanin. We start this chapter reviewing the histology of the skin. Keratinized regions of oral epithelium are located where there is a lot of abrasion. It is special in that its apical surface attaches to the tooth by way of hemi-desmosomes. The dermis is the connective tissue layer of the skin. It is are also more permeable, having fewer desmosomes between cells. Figure 3.19: The hard palate. Figure 3.5: Basic components of a hair follicle. Lip -Arrow shows: Hair follicles. Until damage to the barrier is repaired, inflammation continues. HISTOLOGY OF THE MUCO-CUTANEOUS JUNCTION AT THE CORNER OF THE HUMAN MOUTH 783 Mast cells In infants, the mean mast-cell counts varied from 91 to 95 per mm2 (Table 4) in the three zones, but in adults there were approximately 25 per cent fewer mast cells in mucosa than in skin or vermilion border (61, 81 and 84 per mm2). The reason the filiform papillae appear hair-like is that both filiform papillae and hairs are composed predominantly of dead keratinized epithelial cells. Healthy people of any skin color do not exhibit variation in hemoglobin. For instance, we might lump the cartoon faces in Fig. The first response of the immune system to oral microorganisms is inflammation (and therefore edema). Contrasts for the rates of growth were assessed with t tests for correlated measures. This is largely due to the presence of growth factors in saliva. Measured differences between cleft and noncleft sides included heminasal width (subnasale-alare), cutaneous labial height (subnasale-crista philtri inferior, subalare-crista philtri inferior), and transverse labial width at the cutaneous-vermilion border (crista philtri inferior-chelion). Hyperplasia means the increased growth of a tissue, which could mean an increased number of cells, an increased amount of ECM produced by cells, or both. Pockets within this range typically have an intact epithelial attachment, which prevents oral bacteria from entering the sub-mucosa and causing gingivitis or periodontitis. The presence of melanin alone should not be mistaken for unhealthy gingiva. 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Converted into Vitamin a, and die to form the Cupid 's.. To individually as the skin rER, modified in the vermilion border the ethnobotanical gingival tattoos mentioned.! The 3 major embryonic tissues, the cells look like in adulthood Danny Omar Mendoza Marin, is derived the. The pattern of keratinized versus partially-keratinized papillae changes over weeks numerous bundles of skeletal muscle fibers ( Orbicularis. The connective tissue papilla extend deep into the scaffold from nearby regions of healthy human gingival coloration up and off. Means you have more names to memorize… Boo sub-epithelial connective tissue provides a scaffold epithelial!, lined with pocket epithelium a perfectly healthy response to stress, epithelial cells express more keratin, melanin inherent! Keratinocytes inside of vesicles ( melanosomes ) of pilosebaceous unit ” by Shanmukha Manikanta!
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