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1.13 The Teeth, Palate, Internal Auditory Tube and
Tonsils
Dr. Cinio /Sep 8, 15
1st sem: Prelims
Permanent Teeth / Secondary Dentition
 32 teeth / 16 pairs (8 incisors,
1st term Prelims4 canines, 8 premolars,
12 molars)
 8 teeth in each jaw quadrant
CLINICAL CORRELATION
**Hypodoncha – 1 or 2 pairs of teeth fail to develop (usually
missing is the 3rd molar)
**Hyperdoncha – additional or super numerality of teeth
**In the oral cavity, we have 4 quadrants with the midline as
the landmark
 upper left / upper maxillary quadrant
 upper right / upper maxillary quadrant
 lower left / lower mandibular quadrant
 lower right / lower mandibular quadrant
**Wisdom Teeth / 3rd molar usually ruptures at age 18-21
y/o
** 30% of the population has no wisdom teeth
**Premolars replace the deciduous molars, thus only
restricted to the permanent dentition
Deciduous / Primary Dentition / Milk Teeth
 ruptures starts at age 6mos to 3y/o
 20 deciduous / 10 pairs
 5 deciduous in each jaw quadrant
**Basic tooth forms
 Incisors (used for cutting)
 Canines (used for piercing)
 Molars (used for grinding)
Tooth Surfaces
 Buccal Side (adjacent to lips or cheeks)
 Labial Side
 Lingual Side (adjacent to the tongue)
A. Incisors
 2 in each quadrant
 central and lateral incisor
 tubercle/mamylon (biting edge of the incisor)
B. Canine
 instead of an incisal edge, they have a single cusps,
hence the name cuspid
 have the longest root (canine eminence)
C. Premolars
 have 2 cusps (bicuspid)
 2 premolars in each quadrant, each with a buccal and
lingual cusp
 2% of the population have no premolars
D. Molars
-3 molars in each quadrant
-each has a rectangular or rhomboid surface with 4-5 cusps
**Exposed portion of the teeth is called the crown, while the
embedded part is the root
**In between the crown and root is the cervical margin
**Apical Foramen of the cervical margin– vascular part of the
tooth
**The body of the tooth is mostly made up of dentin
Crown
 covered by enamel
 hardest part of the tooth
 has cementum which gives it a yellowish color
Root
ANATOMY
 embedded within the alveolar bone of the maxilla and
the mandible via the periodontal ligament
*Function of the Periodontal Ligament
 Supports the tooth
 Generates the force of tooth eruption
 Provides sensory information about tooth position
 Contain cells associated with the development and
maintenance of the alveolar bone and cementum
Blood supply of the Teeth
 Maxillary Artery (Terminal branch of the External
Carotid Artery) – Main
 Infraorbital Artery
 Mental Artery
Venous Drainage of the Teeth
 Facial Vein
Lymphatic Drainage of the Teeth
 Cervical Lymph Nodes
 Submandibular Lymph Nodes
Nerve Supply of Maxillary Teeth
 The anterior, superior, posterior alveolar branches of
CN 5.3 (maxillary branch of the trigeminal nerve)
Nerve Supply of the Mandibular Teeth
 The inferior alveolar branch of the mandibular nerve
THE PALATE
 forms the arched roof of the mouth and the floor of the
nasal cavities
 it separates the oral cavity from the nasal cavities and
the nasopharynx (the part of the pharynx superior to
the soft palate)
Hard Palate
 is vaulted (concave); this space is mostly filled by the
tongue when it is at rest
 anterior two thirds of the palate has a bony skeleton
formed by the palatine processes of the maxillae and the
horizontal plates of the palatine bones
 Blood Supply of Hard Palate
Greater and lesser palatine arteries
 Nerve Supply of the Hard Palate
Greater and lesser palatine nerves
 Venous Drainage of the Hard Palate
Pterygoid venous plexus
Soft Palate
 is the movable posterior third of the palate and is
suspended from the posterior border of the hard palate
 has no bony skeleton; however, its anterior aponeurotic
part is strengthened by the palatine aponeurosis
 the aponeurosis is thick anteriorly and thin posteriorly
 posteroinferiorly, the soft palate has a curved free
margin from which hangs a conical process that projects
downward called the uvula
 Blood Supply of the Soft Palate
Ascending palatine branch of the facial artery
 Venous Drainage of the Soft Palate
Pterygoid venous plexus
 Innervation of the Soft Palatine
Lesser palatine nerve
**When the mouth is open wide, the internal posterior boundary
of the cheek serves as a landmark for the inferior alveolar nerve
**The fauces is the space between the cavity of the mouth and the
pharynx. The fauces is bounded superiorly by the soft palate,
inferiorly by the root of the tongue, and laterally by the pillars of
the fauces (palatoglossal and palatopharyngeal arches)
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________________________________________________________ ANATOMY

TONSILS
Palatine Tonsils
 often referred to as “the tonsils,” are masses of
lymphoid tissue, one on each side of the
oropharynx.
 each tonsil is in a tonsillar fossa (sinus),
bounded by the palatoglossal and
palatopharyngeal arches and the tongue

Nasopharyngeal Tonsils / Adenoids

 located at the roof of the nasopharynx
 member of the mucosal asscociated lymphoid
tissue (MALT)

Lingual Tonsils
 located at base of the tongue

Internal Auditory Tube

Pharyngotympanic / Eustachian Tube
 descends anteromedially connecting the
tympanic cavity to the nasopharynx
 it is formed partly by cartilage, fibrous tissue
and bone
 function of the pharyngotympanic tube is to
equalize pressure in the middle ear with the
atmospheric pressure y allowing air to enter
and leave the tympanic cavity, this tube
balances the pressure on both sides of the
membrane.
 near the tube are tonsils called Eustachian
tube tonsils

**The arteries of the pharyngotympanic tube are derived

from the ascending pharyngeal artery, a branch of the
external carotid artery, and the middle meningeal artery
and artery of the pterygoid canal, branches of the
maxillary artery.

**The veins of the pharyngotympanic tube drain into the

pterygoid venous plexus. Lymphatic drainage of the tube
is to the deep cervical lymph nodes. The nerves of the
pharyngotympanic tube arise from the tympanic plexus,
which is formed by fibers of the glossopharyngeal nerve
(CN IX).

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