口腔胚胎及組織學 Oral embryology & histology Mucosa 臺北醫學大學牙醫學系張維仁醫師 cweijen1@tmu.edu.tw 學習目標 能了解頭臉部及口腔之發育 結構與功能, 並發展能有效吸收與傳播相關資訊之辭彙, 將胚胎及組織學上之基本概念, 應用於臨床上之診斷與治療 參考資料 1.Illustrated Dental Embryology, Histology, and Anatomy: Mary Bath-Balogh, Margaret J. Fehrenbach, 2nd Edition, Elsevier Saunders,2006 2.Esstential of Oral Histology and Embryology--A clinical approach: James K Avery, Denial J Chiego,Jr 3rd Edition, Elsevier Mosby, 2006 3.Ten Cate's Oral Histology: Development, Structure, and Function: Nanci Anatonio, 6th ed. Mosby, 2003 Summary 提供學生探討頭臉部及口腔之發育, 認識牙齒及口腔組織之正常顯微結構, 並了解其功能與結構之關係, 進而對生理 病理與臨床牙科學上之問題能做比較與思考, 為各牙科臨床科目之重要基礎課程 Oral moucosa Classification Lining mucosa lip, cheek, soft palate, alveolar mucosa, vestibule Masticatory mucosa gingiva, hard palate Specified mucosa lateral and dorsal surfaces of tongue 1
Lining Mucosa Non-keratinized stratified squamous epithelium Less rete ridge and connective tissue papilla between epithelium and lamina propria Fordyce s spot are present Masticatory Mucosa Keratinized stratified squamous epithelium More rete ridge and connective tissue papilla between epithelium and lamina propria Overlies bone without submucosa Specified Mucosa Lateral and dorsal surface of tongue Composed of epithelium and lamina propria 2
Function of oral mucosa Structure of Mucosa Protection Sensation Thermal regulation Secretion Epithelium Basal Layer Rete peg formation Basal cell attach to lamina desa of the basal lamina by hemidesmosone Anchoring fibrils made of type VII collagen bind to the lamina densa to type I and III collagen Cuboidal or columnar cells Spinous layer Prickle cell layer Cell to cell contact via desmosone Contain keratin filament Large ovoid cells Melanocyte, Langerhan s cell, Merkel Cell 3
Granular layer Contain membrane coating granules,in upper part Flattened cells containing kerathyalin granules associated tonofibrils Keratinized layer Cornified layer, Stratum Corneum Parakeratinization, orthokeratinization Extremely flattened cells and dehydrated cells Epithelium of Oral mucosa Non-keratinized Epitelium Nonkeratinized Orthokeratinized Parakeratinized Orthokeratinized epithelium Parakeratinized epithelium 4
Junction of epithelium and lamina propria Basal lamina Basal membrane Lamina lucida Lamina densa Lamina propria A connective tissue to support oral epithelium Papillary portion Rete ridge to interlock with epithelium Reticular portion (Dense layer) net-like arrangement collagen Capillary Plexus between 2 portions Fibers and ground substances Collagen fibers Elastic fibers Proteoglycans glycoprotein Submucosa Glands, blood vessels, lymph vessels,nerves, adipose tissue Large blood vessel divided into branches to lamina propria Sensory nerve only The sensory nerve terminates into free and organized nerve ending 5
Subdivision of Oral mucosa Hard palate Thick orthokeratinized epithelium Fat and minor salivary gland in submucosa Elongated and numberous epithelial papilla p Desmosone occupy 2 times more area on te surface of the cell than lining mucosa Basal cell contains more ribosome and mitochondria Soft palate Non- keratinized epithelium Covered flexible muscle Lamina propria is thick and high vascularized Few,short papilla in lamina propria Rich elastic fiber 6
Lip Transition zone between oral mucosa and hairy skin called vermilion broader epithelium is thin orthokeratinized and semitrnsparent Lip Intermediate zone dense connective tissue and short,irregular papilla in lamina propria lamina propria connect to thin facia of muscle dense collagen fiber in submucosa 7
Tongue Tongue Mix of keratinized and non-keratinized epithelium on the dorsal surface Non-keratinized epithelium on the lateral and ventral surface The anterior two third are from the first pharyngeal arch,the posterior third from the third pharyngeal arch. The inenervation of anterior two third are from facial nerve, and The inenervation of anterior two third are from glossopharygeal nerve Tongue Fungiform papilla Dome shape and covered by thin keratinized epithelium Anterior third of the tongue Contain taste buds in the apical epithelium Rich innervated and well vascularized connective tissue papilla Filiform papilla Smallest papilla Cone shape and cover a connective tissue core Anterior part of the tongue Foliate papilla Posterior lateral border of tongue 4-11 parallel ridge in dorsoventral direction by mucosal folding Taste buds in the lateral wall Circumvallate papilla largest papilla, few taste buds on the lateral wall in the V shape junction of the posterior 1/3 and anterior 2/3 keratinized epithelium and non-keratinized in the lateral wall salivary gland of Ebner 8
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