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Dental Tissues > Ora Mucosa > Flashcards

Ora Mucosa Flashcards

1
Q

What does the clinical appearance of oral mucosa reflect?

A

It reflects the underlying histology, both in health and disease.

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2
Q

How is the oral cavity often described?

A

It is described as a mirror that reflects the health of the individual.

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3
Q

What changes can indicate disease in the oral mucosa?

A

Alterations in the oral mucosa lining the mouth can indicate systemic conditions.

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4
Q

What are some systemic conditions that may be revealed by changes in the oral mucosa?

A

Examples include diabetes, vitamin deficiencies, and the local effects of chronic tobacco or alcohol use.

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5
Q

What type of tissue almost continuously lines the oral cavity?

A

The oral mucosa almost continuously lines the oral cavity.

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6
Q

What is the microscopic composition of the oral mucosa?

A

It is composed of stratified squamous epithelium overlying connective tissue proper, or lamina propria, with possibly a deeper submucosa.

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7
Q

What lies between the epithelium and connective tissue in the oral mucosa?

A

A basement membrane lies between the epithelium and connective tissue.

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8
Q

Does the basement membrane separate the epithelium and connective tissue?

A

No, it serves as a continuous structure linking the two.

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9
Q

What are the three main types of oral mucosa found in the oral cavity?

A

The three main types are masticatory mucosa, lining mucosa, and specialized mucosa.

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10
Q

Where is masticatory mucosa found, and what are its features?

A

Masticatory mucosa is found on the hard palate, attached gingiva, and dorsum of the tongue. It has keratinized epithelium and a dense lamina propria.

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11
Q

What is the clinical appearance and function of lining mucosa?

A

Lining mucosa has a softer, moister surface that can stretch and compress, acting as a cushion. It includes the buccal mucosa, labial mucosa, alveolar mucosa, and the mucosa lining the floor of the mouth, soft palate, and ventral surface of the tongue.

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12
Q

What type of epithelium does lining mucosa have?

A

Lining mucosa has nonkeratinized stratified squamous epithelium.

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13
Q

What is the function of specialized mucosa in the oral cavity?

A

Specialized mucosa, found in the taste buds on the tongue’s lingual papillae, allows for the perception of taste and includes nerve endings for pain, touch, and temperature.

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14
Q

What are the regional differences in the oral mucosa based on?

A

Regional differences are based on specific histologic features in different regions of the oral cavity.

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15
Q

What do the histologic features of oral mucosa explain?

A

They explain the differences observed clinically when examining these regions.

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16
Q

What are the three types of stratified squamous epithelium found within the oral cavity?

A

The three types are nonkeratinized, keratinized, and parakeratinized epithelium.

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17
Q

What is keratin, and what are its properties?

A

Keratin is a tough, fibrous, opaque, waterproof protein that is impervious to pathogenic invasion and resistant to friction.

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18
Q

Where is keratin produced in the oral mucosa?

A

It is produced during the maturation of keratinocyte epithelial cells as they migrate from the basement membrane to the surface of keratinized tissue.

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19
Q

In which regions of the oral cavity is keratinized tissue found?

A

Keratinized tissue is found in certain regions of the oral mucosa within the oral cavity.

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20
Q

What are the characteristics of lining mucosa?

A

Lining mucosa has a softer surface texture, a moist surface, and can stretch and compress, acting as a cushion for underlying structures.

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21
Q

Which areas of the oral cavity are covered by lining mucosa?

A

Lining mucosa includes the buccal mucosa, labial mucosa, alveolar mucosa, mucosa lining the ventral surface of the tongue, the floor of the mouth, and the soft palate.

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22
Q

What type of epithelium is associated with lining mucosa?

A

Lining mucosa is associated with nonkeratinized stratified squamous epithelium.

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23
Q

How does the interface between the epithelium and lamina propria in lining mucosa compare to that of masticatory mucosa?

A

The interface in lining mucosa is generally smoother with fewer and less pronounced rete ridges and connective tissue papillae compared to masticatory mucosa.

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24
Q

What provides lining mucosa with its movable base or rather what make it be able to stretch and move?

A

The presence of elastic fibers in the lamina propria provides the tissue with a movable base.

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25
Q

What is located deep to the lamina propria in lining mucosa?

A

A submucosa is usually present deep to the lamina propria in lining mucosa.

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26
Q

What does the submucosa in lining mucosa overlie, and what does it allow?

A

It overlies muscle and allows for compression of the superficial tissue.

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27
Q

Why does lining mucosa serve well in regions where a movable base is needed?

A

It is suitable for regions like during speech, mastication, and swallowing due to its compressibility and mobility.

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28
Q

Why do surgical incisions in lining mucosa frequently require sutures?

A

Tissue movement in this area often necessitates sutures for closure.

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29
Q

How does the permeability of lining mucosa affect dental medications?

A

Lining mucosa is the most permeable to liquids, making it easier for dental medications to be absorbed.

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30
Q

How many layers are found within the epithelium of lining mucosa?

A

Each tissue type of lining mucosa has at least three layers within the epithelium.

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31
Q

What is the basal layer in lining mucosa, and where is it located?

A

The basal layer, or stratum basale, is the deepest of the three layers and consists of a single layer of cuboidal epithelial cells overlying the basement membrane.

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32
Q

What is the function of the basal layer in lining mucosa?

A

It is germinative, as mitosis of epithelial cells occurs within this layer.

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33
Q

What does the basal layer produce?

A

It produces the basal lamina of the basement membrane.

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34
Q

What is the intermediate layer in nonkeratinized epithelium, and where is it located?

A

The intermediate layer, or stratum intermedium, is located superficial to the basal layer in nonkeratinized epithelium.

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35
Q

What is the structure of the cells in the intermediate layer?

A

The cells are larger, stacked, and polyhedral-shaped, appearing plumper due to larger amounts of fluid in their cytoplasm.

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36
Q

Do cells in the intermediate layer retain the ability to undergo mitosis?

A

No, the cells in this layer have lost the ability to undergo mitosis.

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37
Q

the intermediate layer of lining epithelium makes up how much of nonkeratinized epithelium?

A

It makes up the bulk of nonkeratinized epithelium.

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38
Q

What is the superficial layer in nonkeratinized epithelium called, and where is it located?

A

It is called the stratum superficiale and is located at the most superficial level in nonkeratinized epithelium.

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39
Q

What is the structure of cells in the superficial layer?

A

The cells are larger, stacked, polyhedral epithelial cells, with the outermost cells flattening into squames.

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40
Q

What happens to the cells in the superficial layer as they age and die?

A

The squames in the superficial layer shed or are lost during tissue turnover.

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41
Q

How does maturation in nonkeratinized tissue compare to keratinized tissue?

A

Maturation in nonkeratinized tissue occurs at a lesser level than in keratinized tissue.

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42
Q

What do the labial mucosa and buccal mucosa line?

A

They line the inner lips and cheeks.

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43
Q

What is the clinical appearance of labial and buccal mucosa?

A

They appear as opaque pink, shiny, moist, compressible tissue that stretches easily, with possible areas of melanin pigmentation.

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44
Q

How are labial and buccal mucosa classified?

A

They are classified as lining mucosa.

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45
Q

What are the histologic features of the labial and buccal mucosa?

A

They have extremely thick nonkeratinized epithelium overlying a lamina propria with extensive vascular supply, giving an opaque pink appearance.

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46
Q

What components in the lamina propria of labial and buccal mucosa allow for stretch and shape retention?

A

Elastic fibers and collagen fibers in the lamina propria give the tissue the ability to stretch and return to its original shape.

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47
Q

What is the role of the submucosa in labial and buccal mucosa?

A

The submucosa contains adipose connective tissue and minor salivary glands, contributing to compressibility and moisture, and is firmly attached to underlying muscle to prevent interference during mastication or speech.

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48
Q

What are Fordyce spots, and where are they located?

A

Fordyce spots (or granules) are small, yellowish bumps scattered throughout the tissue of the labial and buccal mucosa.

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49
Q

Are Fordyce spots harmful?

A

No, they are harmless and present in most of the population.

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50
Q

In which age group are Fordyce spots more prominent?

A

They are more prominent in older individuals than in children or young adults.

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51
Q

Fordyce spots correspond to …..

A

They correspond to deposits of sebum from misplaced sebaceous glands in the submucosa.

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52
Q

What is the usual characteristic of nonkeratinized epithelium compared to keratinized epithelium?

A

Nonkeratinized epithelium usually lacks superficial layers showing keratinization.

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53
Q

What is hyperkeratinization, and what causes it in nonkeratinized epithelium?

A

Hyperkeratinization occurs when nonkeratinized epithelium transforms into keratinized epithelium in response to frictional or chemical trauma.

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54
Q

What oral habits can lead to hyperkeratinization of the buccal mucosa?

A

Habits such as clenching or grinding (bruxism) can lead to hyperkeratinization.

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55
Q

What is linea alba, and where does it form?

A

Linea alba is a white ridge of calloused tissue that forms horizontally at the level where maxillary and mandibular teeth come together and occlude.

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56
Q

What is the clinical appearance of alveolar mucosa?

A

It is a reddish-pink tissue with blue vascular areas, shiny, moist, compressible, and extremely mobile.

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57
Q

How is alveolar mucosa classified?

A

It is classified as lining mucosa.

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58
Q

What type of epithelium does alveolar mucosa have?

A

It has an extremely thin nonkeratinized epithelium.

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59
Q

Why does alveolar mucosa appear redder than labial or buccal mucosa?

A

The thin epithelium overlies but does not obscure an extensive vascular supply in the lamina propria.

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60
Q

What provides the mobility of alveolar mucosa?

A

The presence of numerous elastic fibers in the lamina propria and the loosely attached submucosa provide mobility.

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61
Q

What components are found in the submucosa of alveolar mucosa?

A

The submucosa contains minor salivary glands and numerous elastic fibers in loose connective tissue, allowing for moisture and increased mobility.

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62
Q

What is the clinical appearance of the ventral surface of the tongue and the floor of the mouth?

A

Both appear as reddish-pink tissue with blue vascular areas, shiny, moist, and compressible.

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63
Q

How does the mobility of the floor of the mouth compare to the ventral surface of the tongue?

A

The floor of the mouth has some mobility, while the ventral surface of the tongue is firmly attached yet allows some stretching along with tongue muscles.

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64
Q

How is the ventral surface of the tongue and the floor of the mouth classified?

A

They are classified as lining mucosa.

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65
Q

What is the lingual frenum, and where is it located?

A

The lingual frenum is a midline fold of tissue connecting the ventral surface of the tongue to the floor of the mouth.

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66
Q

What are sublingual folds, and where are they located?

A

The sublingual folds are ridges of tissue on each side of the floor of the mouth, extending from the lingual frenum to the base of the tongue.

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67
Q

What type of epithelium is present in the ventral surfaces of the tongue and floor of mouth regions?

A

Both regions have an extremely thin nonkeratinized epithelium overlying a lamina propria with an extensive vascular supply.

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68
Q

Why do the ventral surface of the tongue and floor of the mouth tissue appear redder and show veins more prominently?

A

The thin epithelium does not obscure the extensive vascular supply, making veins such as the deep lingual veins more apparent.

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69
Q

What are the histologic features of the ventral surface of the tongue?

A

The connective tissue papillae of the lamina propria are numerous, with some elastic fibers and a few minor salivary glands providing stretch and moisture.

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70
Q

How is the submucosa associated with the ventral surface of the tongue?

A

It is extremely thin and firmly attached to the underlying tongue muscle.

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71
Q

How does the attachment of the mucosa and muscle affect function?

A

The mucosa and muscles function as one unit, reducing movability during mastication and speech.

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72
Q

What are the histologic features of the floor of the mouth?

A

The connective tissue papillae of the lamina propria are broad, and the submucosa contains loose connective tissue with adipose tissue and includes the submandibular and sublingual salivary glands.

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73
Q

What gives the floor of the mouth its compressibility and moisture?

A

The adipose connective tissue provides compressibility, while the submandibular and sublingual salivary glands provide moisture.

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74
Q

How is the submucosa attached in the floor of the mouth?

A

It is loosely attached to the underlying bone and muscles, allowing movability when the tongue moves during mastication and speech.

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75
Q

What are mandibular tori, and where do they develop?

A

Mandibular tori are bony growths that develop on the lingual aspect of the mandible.

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76
Q

Are mandibular tori usually benign or malignant?

A

They are usually benign and painless.

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77
Q

When do mandibular tori typically become noticeable?

A

They often go unnoticed unless they become large enough to cause discomfort or complications.

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78
Q

Where are mandibular tori usually located?

A

They are usually present bilaterally in the area of the premolars.

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79
Q

What shapes can mandibular tori take?

A

They can appear lobulated, nodular, or even fused together.

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80
Q

What covers mandibular tori, and do they vary in size?

A

They are covered by oral tissue and can vary in size.

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81
Q

What is the clinical appearance of the soft palate?

A

The posterior part of the palate appears as deep pink with a yellowish hue, has a moist surface, and is compressible and elastic.

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82
Q

How is the soft palate classified?

A

It is classified as lining mucosa.

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83
Q

What type of epithelium does the soft palate have?

A

It has a thin nonkeratinized epithelium overlying a thick lamina propria.

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84
Q

What features of the lamina propria contribute to the soft palate’s mobility?

A

The lamina propria has numerous connective tissue papillae and a distinct elastic layer with elastic fibers.

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85
Q

How is the submucosa of the soft palate attached, and what does this enable?

A

The submucosa is extremely thin and firmly attached to the underlying muscle, allowing for speech and swallowing.

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86
Q

What components of the submucosa give the soft palate its characteristic appearance and properties?

A

The submucosa contains adipose connective tissue (giving a yellow hue and compressibility) and minor salivary glands (providing moisture).

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87
Q

What is the clinical appearance of masticatory mucosa?

A

It has a rubbery surface texture and resiliency.

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88
Q

Where is masticatory mucosa found?

A

It is found in the mucosa of the hard palate, the attached gingiva, and the dorsal surface of the tongue.

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89
Q

What types of epithelium are associated with masticatory mucosa?

A

It is associated with orthokeratinized and parakeratinized stratified squamous epithelium.

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90
Q

How does the interface between epithelium and lamina propria differ in masticatory mucosa compared to lining mucosa?

A

The interface is highly interdigitated with numerous and more pronounced rete ridges and connective tissue papillae, giving it a firm base.

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91
Q

Is the submucosa present in masticatory mucosa, and what is its role?

A

The submucosa is either an extremely thin layer or absent, and when it overlies bone, it increases tissue firmness.

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92
Q

What features allow masticatory mucosa to function in regions that require a firm base?

A

Its histologic features, including keratinization and interdigitated interface, make it suitable for regions needing firmness during mastication and speech.

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93
Q

What distinguishes orthokeratinized stratified squamous epithelium from nonkeratinized tissue?

A

Orthokeratinized epithelium demonstrates keratinization of epithelial cells throughout its most superficial layers.

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94
Q

Where is orthokeratinized stratified squamous epithelium commonly found?

A

It is found in the masticatory mucosa of the hard palate and attached gingiva, and in the specialized mucosa of the lingual papillae on the dorsal surface of the tongue.

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95
Q

What happens to epithelial cells as orthokeratinized tissue matures?

A

Cells form keratin within the superficial layers, creating visible and physiologic differences as they migrate superficially.

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96
Q

How does orthokeratinized epithelium differ in layering compared to nonkeratinized epithelium?

A

Orthokeratinized epithelium has more layers superficial to the basal layer, with four distinct layers.

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97
Q

What is the basal layer in orthokeratinized epithelium called, and what is its function?

A

The basal layer, or stratum basale, is responsible for mitosis and produces the basal lamina of the basement membrane.

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98
Q

What are the two sub-layers of the basal lamina in the basement membrane?

A

The lamina lucida (a clear layer closer to the epithelium) and the lamina densa (a dense layer closer to the connective tissue).

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99
Q

What is the function of the basal layer in epithelial tissue?

A

It generates new cells through mitosis and helps maintain the structural integrity of the basement membrane.

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100
Q

What is the prickle layer in orthokeratinized epithelium, and where is it located?

A

The prickle layer, or stratum spinosum, is located superficial to the basal layer.

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101
Q

What happens to cells as they migrate to the prickle layer?

A

The cells lose the ability to undergo mitosis, which they had in the basal layer.

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102
Q

What is the primary function of the prickle layer in orthokeratinized epithelium?

A

It makes up the bulk of the orthokeratinized epithelium, providing structure and support.

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103
Q

What is the granular layer in orthokeratinized epithelium called, and where is it located?

A

The granular layer, or stratum granulosum, is located superficial to the prickle layer.

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104
Q

What is the structure of the epithelial cells in the granular layer?

A

The cells are flat and stacked in a layer that is three to five cells thick.

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105
Q

What is the most superficial layer in orthokeratinized epithelium?

A

It is the keratin layer, or stratum corneum.

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106
Q

How does the thickness of the keratin layer vary in the oral cavity?

A

The thickness varies depending on the region of the oral cavity.

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107
Q

What is the structure of cells in the keratin layer?

A

The cells are flat, have no nuclei, and their cytoplasm is filled with keratin.

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108
Q

What does the keratin in the keratin layer consist of?

A

It consists of a complex of keratohyaline granules and intermediate filaments, forming a dense, opaque material.

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109
Q

What happens to the outer cells (squames) in the keratin layer?

A

The squames flatten, shed, or are lost as part of tissue turnover because they are no longer viable.

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110
Q

What role do the squames and keratin material play in the epithelium?

A

They form a major part of the epithelial barrier and are continuously renewed as cells mature from deeper layers.

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111
Q

What is the clinical appearance of the hard palate?

A

The anterior part appears as whiter pink tissue that is immobile and firm, with a cushioned feeling in the posterior lateral zones and a firmer feeling in the medial zone.

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112
Q

What structures on the hard palate are firm to the touch?

A

The palatine rugae and the median palatine raphe are firm to the touch.

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113
Q

How is the hard palate classified?

A

It is classified as masticatory mucosa.

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114
Q

What type of epithelium is present in the hard palate? How thick is the lamina propria?

A

It has a thick layer of orthokeratinized epithelium overlying a thick lamina propria.

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115
Q

Where is submucosa present in the hard palate, and what is its function?

A

Submucosa is present only in the lateral zones, providing a cushioned feeling when palpated, and it overlies the bones of the palate.

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116
Q

What does the submucosa in the anterior part of the lateral zone of the hard palate contain?

A

It contains adipose connective tissue.

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117
Q

What does the submucosa in the posterior part of the lateral zone of the hard palate contain?

A

It contains minor salivary glands.

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118
Q

Is the submucosa present in the medial zone of the hard palate?

A

No, the submucosa is absent in the medial zone.

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119
Q

How does the absence of submucosa affect the medial zone of the hard palate?

A

It gives the tissue a firmer feeling when palpated.

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120
Q

What are palatal tori, and where are they located?

A

Palatal tori are bony growths that develop on the midline of the hard palate.

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121
Q

Are palatal tori usually benign or malignant?

A

They are usually benign and painless.

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122
Q

How do palatal tori typically appear?

A

They can appear lobulated or nodular and are covered in oral tissue.

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123
Q

What type of epithelium is associated with the masticatory mucosa of the attached gingiva?

A

Parakeratinized stratified squamous epithelium.

124
Q

Where are higher levels of parakeratinized epithelium found compared to orthokeratinized epithelium?

A

In the attached gingiva.

125
Q

What is the relationship between parakeratinized epithelium and lingual papillae?

A

It is associated with the specialized mucosa of the lingual papillae on the dorsal surface of the tongue.

126
Q

What are the layers present in parakeratinized epithelium?

A

It may have all the same layers as orthokeratinized epithelium (basal layer, prickle layer, granular layer, and keratin layer), but the granular layer may be indistinct or absent.

127
Q

How does the keratin layer in parakeratinized epithelium differ from that in orthokeratinized epithelium?

A

In parakeratinized epithelium, the keratin layer contains cells with both keratin and nuclei, unlike the keratinized layer in orthokeratinized epithelium.

128
Q

How is the keratin layer in parakeratinized epithelium maintained?

A

Cells in the keratin layer are shed and lost, similar to those in orthokeratinized epithelium.

129
Q

What is the clinical appearance of healthy attached gingiva?

A

It is opaque pink, with possible areas of melanin pigmentation, and when dried, it appears dull, firm, and immobile.

130
Q

What is stippling, and how does it appear on the attached gingiva?

A

Stippling appears as small pinpoint depressions, giving the surface an orange-peel appearance.

131
Q

What type of epithelium predominates in the attached gingiva?

A

A thick layer of mostly parakeratinized epithelium, with minor amounts of orthokeratinized epithelium.

132
Q

What gives the attached gingiva its pink and opaque appearance?

A

The thick parakeratinized epithelium obscures the extensive vascular supply in the lamina propria.

133
Q

What is the structure of the lamina propria in the attached gingiva?

A

It has tall and narrow connective tissue papillae.

134
Q

Does the attached gingiva have a submucosa?

A

No, the lamina propria is directly attached to the underlying alveolar process, making the tissue firm and immobile.

135
Q

What is the clinical appearance of the mucogingival junction?

A

It is a sharply defined, scalloped junction between the pinker attached gingiva and the redder alveolar mucosa.

136
Q

How is the mucogingival junction classified histologically?

A

It is a dividing zone between the keratinized attached gingiva and the nonkeratinized alveolar mucosa.

137
Q

What histological differences exist on either side of the mucogingival junction?

A

The pinkish attached gingiva has a thick epithelial layer, while the redder alveolar mucosa has a thin epithelial layer.

138
Q

What types of mucosa meet at the mucogingival junction?

A

Masticatory mucosa (attached gingiva) and lining mucosa (alveolar mucosa).

139
Q

What are exostoses, and where do they develop?

A

Exostoses are bony growths that develop on the facial/buccal surface of the alveolar processes.

140
Q

Are exostoses usually benign or malignant?

A

They are usually benign and painless.

141
Q

When do exostoses typically become noticeable?

A

They often go unnoticed unless they grow large enough to cause discomfort or complications.

142
Q

How do exostoses typically appear?

A

They may appear unilaterally or bilaterally in the premolar and molar regions and can be lobulated or nodular.

143
Q

What covers exostoses, and do they vary in size?

A

They are covered by oral tissue and can vary in size.

144
Q

What is gingival hyperplasia?

A

Gingival hyperplasia is the overgrowth of the interproximal gingiva.

145
Q

What can cause gingival hyperplasia?

A

It can be caused by certain drugs, such as seizure control medications (phenytoin sodium), antibiotics, or specific heart medications.

146
Q

What layers of the gingival tissue can gingival hyperplasia affect?

A

It can affect both the epithelium and the lamina propria.

147
Q

Can gingival hyperplasia be localized or generalized?

A

Yes, it can be either localized or generalized.

148
Q

What layers are present in all forms of oral mucosa epithelium?

A

All forms of oral mucosa epithelium have a lamina propria deep to the basement membrane.

149
Q

What is the main fiber group in the lamina propria?

A

The main fiber group is Type I collagen fibers.

150
Q

What are the two layers of the lamina propria?

A

The papillary layer (superficial, with loose connective tissue, blood vessels, and nerve tissue) and the dense layer (deeper, with dense connective tissue and many fibers).

151
Q

What lies between the papillary and dense layers of the lamina propria?

A

The capillary plexus, which provides nutrition to the layers.

152
Q

What is the most common cell in the lamina propria?

A

The fibroblast, which synthesizes protein fibers and intercellular substance.

153
Q

Is submucosa always present in the oral cavity?

A

No, submucosa may or may not be present deep to the dense layer of the lamina propria, depending on the region.

154
Q

What does the submucosa typically contain if present?

A

It usually contains loose connective tissue and may include adipose tissue or salivary glands.

155
Q

What structures might the submucosa overlie in the oral cavity?

A

It may overlie bone or muscle.

156
Q

What tissues make up the major and minor salivary glands?

A

They are composed of epithelium and connective tissue.

157
Q

What are the cells that produce saliva called?

A

They are called secretory cells.

158
Q

What are the two types of secretory cells?

A

The two types are mucous cells and serous cells.

159
Q

What is an acinus, and what is its structure?

A

An acinus is a group of secretory cells surrounded by a single layer of cuboidal epithelial cells with a central opening called a lumen where saliva is deposited.

160
Q

What is the role of connective tissue in salivary glands?

A

The connective tissue forms the capsule surrounding the gland and the septa, which divide the gland into lobes and lobules.

161
Q

What do serous salivary glands produce?

A

They produce a watery, thin fluid rich in digestive enzymes like amylase.

162
Q

What is an example of a serous salivary gland?

A

The parotid gland.

163
Q

What do mucous salivary glands produce?

A

They produce a thick, viscous mucus containing mucin, which acts as a lubricant.

164
Q

What is an example of a mucous salivary gland?

A

The sublingual gland.

165
Q

What are mixed salivary glands, and what do they contain?

A

Mixed salivary glands contain both serous and mucous cells.

166
Q

What is an example of a mixed salivary gland?

A

The submandibular gland.

167
Q

What causes pigmentation in the oral mucosa?

A

Pigmentation is caused by melanin, a pigment formed by melanocytes.

168
Q

Where are melanocytes located in the oral mucosa?

A

They are found in the basal layer of the stratified squamous epithelium.

169
Q

What are melanosomes, and what is their function?

A

Melanosomes are small cytoplasmic granules in melanocytes that store melanin pigment and inject it into neighboring basal epithelial cells.

170
Q

How does melanin pigmentation appear clinically?

A

It appears as localized flat areas ranging in color from brown to brownish black.

171
Q

What happens to pigmented cells during tissue regeneration?

A

Pigmented cells migrate to the surface of the oral mucosa during turnover.

172
Q

How does the turnover time of oral mucosa compare to that of skin?

A

The turnover time of oral mucosa is faster than that of skin.

173
Q

Which region of the oral cavity has the fastest turnover time?

A

The junctional epithelium of the gingival sulcular region, with a turnover time of 4 to 6 days.

174
Q

Which region of the oral cavity has the slowest turnover time?

A

The hard palate, with a turnover time of 24 days.

175
Q

What is the range of turnover times for other oral mucosa regions?

A

Turnover times range between 4 and 24 days.

176
Q

What happens initially after an injury to the oral mucosa?

A

A clot forms from blood products, and the inflammatory response is triggered by white blood cells.

177
Q

How does epithelial repair begin in the oral mucosa?

A

Epithelial cells at the periphery of the injury lose their desmosomal junctions and migrate to form a new epithelial surface layer beneath the clot.

178
Q

Why is the clot important in the repair process?

A

The clot acts as a guide for forming a new epithelial surface and must be retained during the early days of repair.

179
Q

What tissue forms during the repair of the lamina propria?

A

Fibroblasts migrate to produce granulation tissue, which is immature connective tissue with fewer fibers and increased blood vessels.

180
Q

What replaces granulation tissue during healing?

A

Firmer, paler scar tissue replaces granulation tissue as healing progresses.

181
Q

How does scar tissue in oral mucosa compare to scar tissue in the skin?

A

Oral mucosa has less scar tissue because it contains fewer fibers than the skin.

182
Q

How is the tongue divided anatomically by the sulcus terminalis?

A

The sulcus terminalis divides the tongue into an anterior two-thirds (oral part) and a posterior one-third (pharyngeal part).

183
Q

What is the foramen cecum, and where is it located?

A

It is a small pit-like depression located at the point where the sulcus terminalis points toward the pharynx.

184
Q

What is the midline depression on the dorsal surface of the tongue called?

A

It is called the median lingual sulcus.

185
Q

What is the pharyngeal part of the tongue, and where is it located?

A

The pharyngeal part, or base of the tongue, is the posterior one-third and lies within the oral part of the pharynx.

186
Q

What is the oral part of the tongue, and where is it located?

A

The oral part, or body of the tongue, is the anterior two-thirds and lies within the oral cavity proper.

187
Q

What is the lingual tonsil, and where is it located?

A

The lingual tonsil is an irregular mass of tissue located on the dorsal surface of the tongue’s base.

188
Q

What is visible on the ventral surface of the tongue?

A

Large blood vessels called deep lingual veins and fringelike projections called the plica fimbriata are visible.

189
Q

What type of muscle forms the core of the tongue?

A

The tongue’s core consists of striated muscle.

190
Q

How do the muscle bundles differ between the anterior and posterior parts of the tongue?

A

In the anterior part, the muscle bundles are tightly packed with little intervening adipose tissue, while in the posterior part, adipose tissue is more abundant.

191
Q

Where are minor salivary glands most numerous in the tongue?

A

They are numerous in the submucosa and muscular core of the posterior part of the tongue, particularly near the junction of the anterior and posterior parts.

192
Q

What types of mucosa are present on the dorsal surface of the tongue?

A

The dorsal surface has both masticatory mucosa and specialized mucosa.

193
Q

What type of epithelium is associated with the masticatory mucosa of the tongue?

A

It is generally covered by orthokeratinized stratified squamous epithelium.

194
Q

What is the specialized mucosa on the dorsal surface of the tongue associated with?

A

It is associated with the lingual papillae.

195
Q

What are the lingual papillae?

A

They are small, discrete structures or appendages of keratinized epithelium with both orthokeratinized and parakeratinized epithelium overlying a lamina propria.

196
Q

Where are lingual papillae found on the tongue?

A

They are found on both the dorsal and lateral surfaces of the tongue.

197
Q

What types of lingual papillae are associated with taste buds?

A

Fungiform, foliate, and circumvallate papillae.

198
Q

What is a taste bud, and what is its structure?

A

A taste bud is a barrel-shaped organ of taste composed of 30 to 80 spindle-shaped cells extending from the basement membrane to the epithelial surface of the lingual papilla.

199
Q

What is the turnover time for taste bud cells?

A

The turnover time for taste bud cells is about 10 days.

200
Q

What are the two types of cells found in taste buds?

A

Supporting cells and taste cells.

201
Q

Where are supporting cells located in the taste bud, and what is their function?

A

Supporting cells are located on the outer part of the taste bud and help maintain its structure.

202
Q

Where are taste cells located in the taste bud, and what is their function?

A

Taste cells are located in the central part and have superficial taste receptors that detect dissolved food molecules.

203
Q

What is a taste pore, and what is its role?

A

A taste pore is an opening in the most superficial part of the taste bud, where dissolved food molecules contact taste receptors.

204
Q

How do sensory neuron processes interact with taste buds?

A

Sensory neuron processes are located among the cells in the inferior part of the taste bud and receive taste sensation messages.

205
Q

How is taste sensation transmitted to the brain?

A

Messages from taste receptors are sent to the central nervous system via connecting nerves, where they are identified as specific tastes.

206
Q

What factors can affect taste perception?

A

Factors include aging, color/vision impairments, hormonal influences, genetic variations, oral temperature, drugs and chemicals, CNS tumors (especially temporal lobe lesions), and congested noses.

207
Q

How are the four fundamental taste sensations differentiated?

A

They are differentiated due to four slightly different types of taste cells.

208
Q

How are the tastes experienced on the tongue?

A

Tastes are a result of blending the four fundamental sensations (sweet, sour, salty, and bitter) with other sensations from the tongue and interplay with smell.

209
Q

Can all regions of the tongue with taste buds detect all taste sensations?

A

Yes, all qualities of taste can be elicited from all regions of the tongue that contain taste buds.

210
Q

Has the traditional idea of tongue taste mapping been proven correct?

A

No, studies have shown that the concept of specific taste regions on the tongue is false.

211
Q

What are the four types of lingual papillae?

A

The four types are filiform, fungiform, foliate, and circumvallate papillae.

212
Q

Which type of lingual papillae is most common?

A

Filiform papillae are the most common.

213
Q

Where are filiform papillae located, and what do they look like?

A

They are located on the body of the dorsal surface of the tongue and are shaped like fine-pointed cones about 2 to 3 mm long.

214
Q

What function do filiform papillae serve?

A

They provide the velvety texture of the tongue and are sensitive to changes in the body.

215
Q

Do filiform papillae contain taste buds?

A

No, filiform papillae do not contain taste buds.

216
Q

What causes the white appearance of filiform papillae?

A

The increased amount of keratin at the surface forms a “snow-covered Christmas tree” arrangement.

217
Q

What is geographic tongue, and how does it appear clinically?

A

Geographic tongue appears as red and paler pink to white patches on the body of the tongue, resembling a geographic map, with patches that change shape over time.

218
Q

What other names are used for geographic tongue?

A

It is also known as benign migratory glossitis or erythema migrans.

219
Q

What causes the red and white patches in geographic tongue?

A

The red patches correspond to areas of filiform papillae undergoing parakeratinization, while the white patches correspond to areas undergoing orthokeratinization.

220
Q

Is geographic tongue associated with any symptoms?

A

It may be associated with soreness or a slight burning sensation on the tongue’s surface.

221
Q

What is black hairy tongue, and what causes it?

A

Black hairy tongue occurs when the usual shedding of the filiform papillae does not occur, leading to a thick layer of dead cells and keratin that becomes stained by tobacco, medicines, or chromogenic bacteria.

222
Q

Can fungal overgrowth contribute to black hairy tongue?

A

Yes, fungal overgrowth, possibly due to high doses of antibiotics or radiation therapy, can contribute to black hairy tongue.

223
Q

How can black hairy tongue be managed?

A

Brushing the tongue is recommended to promote tissue shedding and remove debris.

224
Q

Should black hairy tongue be recorded in a patient’s chart?

A

Yes, it should be noted in the patient record if present.

225
Q

What is hairy leukoplakia, and how does it appear clinically?

A

It is an irregular and corrugated white lesion that commonly occurs on the lateral border of the tongue.

226
Q

What is the primary cause of hairy leukoplakia?

A

Epstein-Barr virus (EBV) is considered the primary cause of the lesion.

227
Q

In which patients is hairy leukoplakia most commonly found?

A

It is most commonly found in patients with HIV but can also occur in those who are not HIV-infected.

228
Q

Why is brushing the dorsal surface of the tongue important?

A

Brushing the tongue is important for overall oral hygiene and to reduce bad breath (halitosis).

229
Q

What contributes to bad breath in the oral cavity?

A

Microbial colonization by dental biofilm on the tongue’s surface is a significant contributing factor to bad breath.

230
Q

Where are fungiform papillae located, and what is their clinical appearance?

A

They are located on the body of the dorsal surface of the tongue and appear as reddish dots that are slightly raised and mushroom-shaped, with a diameter of about 1 mm.

231
Q

Are fungiform papillae found near the sulcus terminalis?

A

No, they are not found near the sulcus terminalis.

232
Q

What are the histologic features of fungiform papillae?

A

They have a thin layer of orthokeratinized or parakeratinized epithelium overlying a highly vascularized core of lamina propria, giving them their redder appearance.

233
Q

Do fungiform papillae contain taste buds?

A

Yes, a variable number of taste buds are located in the most superficial part of the epithelial layer.

234
Q

What is the primary function of fungiform papillae?

A

Their function is taste sensation.

235
Q

Where are foliate papillae located, and what is their clinical appearance?

A

They are located on the lateral surface of the tongue in its most posterior part and appear as 4 to 11 vertical ridges running parallel to each other.

236
Q

Are foliate papillae often mistaken for other conditions?

A

Yes, they can occasionally be mistaken for tumors or inflammatory disease.

237
Q

What are the histologic features of foliate papillae?

A

They are leaf-shaped structures with a layer of orthokeratinized or parakeratinized epithelium overlying a core of lamina propria.

238
Q

Do foliate papillae contain taste buds?

A

Yes, taste buds are located in the epithelial layer on the lateral parts of the leaf-shaped structures.

239
Q

What is the primary function of foliate papillae?

A

Their function is taste sensation.

240
Q

Where are circumvallate papillae located, and what is their clinical appearance?

A

They are located on the dorsal surface of the tongue, just anterior to the sulcus terminalis, and appear as 7-15 large, raised, mushroom-shaped structures arranged in an inverted V-shape.

241
Q

How does the size of circumvallate papillae compare to other papillae?

A

They are larger than fungiform papillae, measuring 3 to 5 mm in diameter.

242
Q

What are the histologic features of circumvallate papillae?

A

They are surrounded by orthokeratinized or parakeratinized epithelium overlying a core of lamina propria, with hundreds of taste buds located in the epithelium around the entire base.

243
Q

What is the function of von Ebner salivary glands associated with circumvallate papillae?

A

These serous salivary glands flush the area around the taste pores to allow new taste sensations to be introduced.

244
Q

What is the primary function of circumvallate papillae?

A

Their function is taste sensation.

245
Q

What is a fissured tongue, and how is it characterized?

A

A fissured tongue is a condition characterized by grooves of varying depth along the dorsal and lateral aspects of the tongue.

246
Q

What is the suspected cause of a fissured tongue?

A

Although the exact cause is unknown, it is suspected to have a polygenic mode of inheritance and often recurs in families.

247
Q

Is a fissured tongue symptomatic?

A

No, patients are usually asymptomatic, and it is often found incidentally during routine intraoral examinations.

248
Q

What conditions are associated with a fissured tongue?

A

It is frequently seen in Down syndrome and in association with geographic tongue.

249
Q

Where in the oral cavity is oral cancer most commonly found?

A

One of the most common sites is the lateral border of the tongue.

250
Q

How does oral cancer on the tongue initially present?

A

It is initially asymptomatic and painless, with a flat lesion.

251
Q

What happens as oral cancer on the tongue progresses?

A

The lesion may become painful as it invades surrounding nerve tissue and can develop into an exophytic growth, protruding outward from the surface.

252
Q

What is the attached gingiva, and where is it located?

A

The attached gingiva is the gingival tissue that tightly adheres to the bone around the roots of the teeth.

253
Q

What is interdental gingiva, and what does it form?

A

Interdental gingiva is an extension of attached gingiva between adjacent teeth, forming the interdental papillae.

254
Q

What is the gingival col, and how is it shaped?

A

The gingival col is a nonvisible concave shape between the facial and lingual gingival surfaces, apical to the contact area.

255
Q

What factors influence the depth and width of the gingival col?

A

The depth and width vary depending on the expanse of the contacting tooth surfaces.

256
Q

How is attached gingiva classified?

A

It is classified as masticatory mucosa.

257
Q

What is the clinical appearance of healthy attached gingiva?

A

It is pink, firm, and immobile, with possible areas of melanin pigmentation and varying amounts of stippling.

258
Q

What is the marginal gingiva, and where is it located?

A

The marginal gingiva (or free gingiva) is located at the gingival margin of each tooth and is continuous with the attached gingiva.

259
Q

How does the marginal gingiva differ from attached gingiva in clinical appearance?

A

While both appear pink, dull, and firm, the marginal gingiva lacks stippling and is mobile or free from the underlying tooth surface.

260
Q

What separates the attached gingiva from the marginal gingiva?

A

The free gingival groove separates these two types of gingiva.

261
Q

How is the marginal gingiva classified?

A

It is also classified as masticatory mucosa.

262
Q

What type of epithelium covers the attached gingiva?

A

The attached gingiva is covered by a thick layer of mostly parakeratinized stratified squamous epithelium.

263
Q

What feature of the lamina propria gives the attached gingiva its stippling appearance?

A

The tall, narrow connective tissue papillae in the lamina propria alternate with rete ridges, giving it a stippled appearance.

264
Q

How is the interface between the epithelium and lamina propria in attached gingiva described?

A

It is highly interdigitated, contributing to its firmness and immobility.

265
Q

What makes the attached gingiva firm and immobile?

A

The lamina propria is directly attached to the underlying bony jaws.

266
Q

What type of epithelium covers the marginal gingiva?

A

The marginal gingiva has an overlying layer of orthokeratinized stratified squamous epithelium.

267
Q

Why is the marginal gingiva more mobile than attached gingiva?

A

It is not attached to the underlying bony alveolar process.

268
Q

What type of tissue is found in the col area of the gingiva?

A

The tissue in the col is nonkeratinized.

269
Q

What is biologic width?

A

Biologic width is the microscopic distance between the base of the gingival sulcus and the crest of the alveolar bone.

270
Q

Which structures form the biologic width?

A

The junctional epithelium and connective tissue attachment to the root surface of a tooth.

271
Q

What is the commonly stated measurement for biologic width?

A

The biologic width is commonly stated to be 2.04 mm.

272
Q

Why is biologic width important for clinicians?

A

It is crucial for determining the position of restorative margins and their impact on postsurgical tissue position.

273
Q

What are two possible outcomes if restorative margins violate the biologic width?

A

Bone resorption may occur to recreate space for the biologic width, or more commonly, gingival inflammation develops around the tooth.

274
Q

Why is biologic width a significant consideration for anterior restorations?

A

Inflammation caused by violations can compromise the esthetic and functional outcomes of anterior restorations.

275
Q

What is the dentogingival junction?

A

It is the junction between the tooth surface and the gingival tissue.

276
Q

What two types of epithelium form the dentogingival junctional tissue?

A

The sulcular epithelium (SE) and the junctional epithelium (JE).

277
Q

What does the sulcular epithelium (SE) create?

A

It stands away from the tooth, creating the gingival sulcus.

278
Q

What fills the gingival sulcus?

A

The sulcus is filled with gingival crevicular fluid (GCF).

279
Q

What is the source of gingival crevicular fluid (GCF)?

A

It originates from the adjacent blood supply in the lamina propria.

280
Q

What components are found in gingival crevicular fluid (GCF)?

A

It contains immunologic components, blood cells, and sticky plasma proteins that help adhere the lining tissue.

281
Q

What is the average depth of a healthy gingival sulcus?

A

The depth varies from 0.5 to 3 mm, with an average of 1.8 mm.

282
Q

What is the junctional epithelium (JE), and where is it located?

A

The JE is a deeper extension of the sulcular epithelium that lines the floor of the gingival sulcus and is attached to the tooth surface.

283
Q

How is the junctional epithelium attached to the tooth?

A

It is attached by way of an epithelial attachment (EA).

284
Q

How does the JE surround the tooth?

A

It surrounds the tooth like a turtleneck, forming a cross-section resembling a thin wedge.

285
Q

What does the free gingival groove correspond to in the JE?

A

The free gingival groove on the outer surface corresponds to the apical border of the inner JE but not to the depth of the gingival sulcus.

286
Q

What type of epithelium makes up the sulcular epithelium (SE)?

A

The SE consists of stratified squamous epithelium.

287
Q

How is the SE related to the surrounding gingival tissue?

A

It acts as a transition tissue between the gingival epithelium and the junctional epithelium.

288
Q

Is the sulcular epithelium keratinized?

A

No, the SE is nonkeratinized, unlike the keratinized marginal and attached gingiva.

289
Q

How does the interface between the SE and the lamina propria differ from other gingival tissues?

A

The interface is relatively smooth compared to the strongly interdigitated interface of the marginal and attached gingiva.

290
Q

What is the interface between the junctional epithelium (JE) and the lamina propria like?

A

It is also relatively smooth, without rete ridges or connective tissue papillae.

291
Q

What is periodontal disease?

A

It is an inflammatory disease that affects the soft and hard structures supporting the teeth.

292
Q

What are the two stages of periodontal disease?

A

The early stage is gingivitis, and the later stage is periodontitis.

293
Q

How does gingivitis differ from periodontitis?

A

Gingivitis involves inflammation with no loss of attachment and is reversible, while periodontitis involves loss of periodontal structures and is irreversible.

294
Q

What happens to the gingiva during active periodontal disease?

A

Both the marginal and attached gingiva, especially the interdental papillae, may become enlarged and spongy due to edema in the lamina propria.

295
Q

What is McCall’s festoon, and how does it appear?

A

McCall’s festoon is a lifesaver-shaped edema of the marginal gingiva caused by the inflammatory response.

296
Q

What is gingival recession?

A

It is the apical migration of the gingival margin.

297
Q

What are some causes of gingival recession?

A

Causes include periodontal disease, tooth position, incorrect toothbrushing methods, abfraction from occlusal stress, a thin scalloped gingival biotype, aging, and tight frenal attachments.

298
Q

What is a Stillman cleft, and what causes it?

A

A Stillman cleft is a cleft-like area of gingival recession, often related to occlusal trauma such as bruxism, clenching, or misaligned bites.

299
Q

What is a key clinical sign of active periodontal disease?

A

Bleeding on probing (BOP) is one of the first clinical signs.

300
Q

Why does bleeding occur during probing in gingivitis?

A

The periodontal probe damages the increased blood vessels in the capillary plexus of the lamina propria, which are closer to the surface due to ulceration of the junctional epithelium.

301
Q

Does bleeding on probing indicate that the clinician is hurting the patient?

A

No, BOP occurs even with a gentle touch and indicates inflammation.

302
Q

Why do patients who use nicotine products rarely show bleeding on probing?

A

Nicotine causes vasoconstriction, narrowing the blood vessels and reducing bleeding.

303
Q

How should bleeding on probing be recorded?

A

It should be documented per individual tooth and surface in the patient’s chart.

304
Q

What happens to the amount of gingival crevicular fluid (GCF) during periodontal inflammation?

A

The amount of GCF increases to fight microbial attacks against periodontal pathogens.

305
Q

What passes through the epithelial wall during periodontitis?

A

Relatively large amounts of fluid pass through the more permeable epithelial wall.

306
Q

What forms when GCF contains cellular debris and large populations of PMNs (polymorphonuclear leukocytes)?

A

It forms a whitish exudate, also known as suppuration or pus.

307
Q

How is suppuration clinically observed?

A

It is noted as visible white fluid resulting from cellular debris and inflammation.

Dental Tissues (20 decks)

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