Oral Histology and Embryology

(3 chrs)
for Dental students
Fikre Bayu

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 General objectives
• Describe, compare and illustrate the histological
characteristics of oral tissues
• To develop a comprehension of the principles of
embryogenesis and human development with
emphasis the face and structures of oral cavity

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 Introduction
• Oral histology is the study of microscopic
structures, compositions and functions of oral
tissues
• It describes in detail the tissues of
– Surrounding oral mucosa
– The teeth
– Periodontium

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 Cont.…
• Oral embryology deals the development of
different orofacial tissues
–Teeth
–Face
• Soft tissues
• Hard tissues
• Developmental anomalies

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 Cont.…

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 Regional Modification of Oral Mucosa
• Oral mucosa shows regional structural
modifications according to the stress, strain and
workload borne by it
• The areas which are well-protected from
masticatory stress and wear and tear, are thin and
delicate, like the mucosa of the floor of the mouth
and the mucosa of cheek; in comparison the areas
involved in mastication of food and stress-bearing
are tough, thick and keratinized like the mucosa of
the gingiva and the hard palate
 Organization of Oral Mucosa
• Oral cavity is divided into outer vestibule and
oral cavity proper
• Outer vestibule: It is the area bounded by lips,
cheeks, alveolar bone and teeth, that is the
areas outside teeth and jaws
• Oral cavity proper: Separated from the outer
vestibule by the alveolus bearing the teeth
that is areas inside the teeth and jaws
 Cont.…
• Boundaries of Oral Cavity
– Superior border: Formed by hard and soft palate
– Inferior border: Floor of mouth and base of
tongue
– Posterior border: Pillars of fauces and tonsils
– Anterior and anterolateral borders: By the lips and
cheeks
Cont.…
 Cont.…
• The intestinal tract (through oral cavity and
anus), nasal passage and other body cavities
communicate with the exterior environment
• All these are lined by a moist lining, which is
called as ‘mucous membrane’
• The moist lining of the oral cavity that is in
continuation with the exterior surface of skin on
one end and esophagus on the other end is
called ‘the oral mucosa or oral mucous
membrane
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 Histology of mouth
The walls of the oral cavity consist of just a few
layers of tissue
an internal mucosa made of an epithelium and
lamina propria, a thin Submucosa in some areas,
and an external layer of muscle or bone
The lining of the mouth, a thick stratified
squamous epithelium, protects it from abrasion
by sharp pieces of food during chewing
On the tongue, palate, lips, and gums this
epithelium may show slight keratinization, which
provides extra protection against abrasion
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 Functions of oral mucosa
• Main functions of oral mucous membrane are as
follows:
Protection: As a surface lining, oral mucosa
separates and protects deeper tissues and organs in
oral region from the following
– Environment of oral cavity
– Mechanical forces of biting and mastication, to
surface abrasion from hard particles in the diet
– Microorganisms that may cause infection if they get
access into the underlying tissue
– Toxins produced by microorganisms
 Cont.…
Sensation: Rich innervation of oral mucosa
makes it a very good receptor of temperature,
touch, pain and taste
– Certain reflexes such as swallowing, salivation and
gagging are also initiated by the receptors in the oral
mucosa
– Certain other reflexes in the oral mucosa respond to
taste of water and signal the satisfaction of thirst
 Cont.…

• Thermal regulation: Thermal regulation function

is quite obvious in some animals such as dogs
– In these animals, considerable amount of body heat
is dissipated through the oral mucosa by panting
– There is no specialized blood vessels for controlling
heat transfer in human oral mucosa, so it plays little
part in regulation of body temperature
 Cont.…
• Secretion: Various major and minor mucous and
serous salivary glands open into the oral cavity
and make it moist which helps in the
mastication of food, its swallowing and
digestion
– The major secretion associated with oral
mucosa is the saliva
 Cont.…
• The oral mucosa
• The surface of the oral mucosa consists of epithelial
tissue
• Epithelial tissue is first classified according to the
shape of the cells as being squamous (flat cells),
cuboidal (cube shaped) or columnar (tall, narrow cells)
and second by the number of cell layers
• A single layer of epithelial cells is called simple and
where there are several layers it is called stratified
• The oral mucosa consists of:
– A surface layer of stratified squamous epithelium
– Underneath this there is a layer of highly vascular
connective tissue, the lamina
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propria 16
 Cont.…
• The mucous membrane is attached to underlying
structures by connective tissue of varying
thickness (the submucosa layer), which contains
larger arteries, veins and nerves

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 Cont.…
• The structure of the mucous membrane varies in
different parts of the oral cavity according to the
variation in function
• In areas subject to chewing such as the hard palate
and the attached gingivae, the mucosa has a firm
keratinized epithelial layer of fibrous protein
• In other areas such as the cheeks and floor of the
mouth that require more flexibility, this is reduced or
absent
• The cells of this keratin layer have no nuclei and no
nerve supply
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 Cont.…
• Underneath the keratinized layer of cells is a non-
keratinized layer of epithelial cells which have
nuclei and act as cushion against mechanical forces
• The deepest layer of these cells is known as the
basal layer and is attached to the basal lamina
• The oral cavity is kept lubricated by mucus
secretions from the major and minor salivary
glands; this epithelium is sometimes termed
mucous membrane

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Keratinized Vs Non-keratinized

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 Cont.…
• There are three types of oral mucosa found in the oral
cavity (lining, masticatory and specialized)
Lining or reflecting mucosa: It covers the
musculature and is distensible
– It is exposed to very mild forces and adapts itself to the
movements of cheeks, lips, and tongue and of the
mandible
– It lines most of the surfaces of the oral cavity (covers lip,
cheek, vestibular fornix, floor of mouth, soft palate and
alveolar mucosa) except the areas of masticatory mucosa
and dorsum of the tongue
– It constitutes 60% of total oral mucosa
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 The Lips
• Muscular folds surrounding the oral orifice
• Covered externally by skin and internally by mucous membrane;
in between orbicularis oris muscle
• Has 3 regions: cutaneous zone, vermillion and mucosal zone
• Attached to gingivae by fold of mucous membrane called labial
frenulum

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 Cont.…
• The external aspect of the lip is covered with thin skin
and is associated with sweat glands, hair follicles, and
sebaceous glands (keratinized stratified squamous
epithelium)
• This region is continuous with the vermilion zone, the
pink region of the lip, which is also covered by thin skin
• However, the vermilion zone is devoid of sweat glands
and hair follicles, although occasional, nonfunctional
sebaceous glands are present there
• it tends to become dry, often becoming cracked and
sore in cold weather
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 Cont.…
• Between the vermilion border and the thicker non-
keratinized labial mucosa, is an intermediate zone
covered by parakeratinized oral epithelium
• The interdigitation between the epithelial and
connective tissue components of the oral mucosa is
highly developed, so that the capillary loops of the
dermal papillae are close to the surface of the skin,
imparting a pink color to the vermilion zone
• In infants, this region is thickened as an adaptation
to suckling and is called the suckling pad
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 Cont.…
On the internal aspect, the lip is covered by a mucous
membrane consisting of stratified squamous non-
keratinized epithelium lying upon a connective tissue lamina
propria with high papillae within the connective tissue are
numerous small mucous glands (the labial glands)

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 Skin of the Lip Vermillion Zone and Labial Mucosa

A: Sweat glands A: Vermillion zone

B: Sebaceous glands B: Labial mucosa
C: Hair follicles C: Orbicularis oris muscle

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 Soft palate

1. Nonkeratinized
A: Hard Palate 2. Highly vascularized so more pink
B; Soft palate than hard palate
C: Nasal cavity
2. Lamina propria and submucosa
present (unlike hard palate when
only lamina propria is noted –
mucoperiosteum)
3. Submucosa contains salivary
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glands and muscle soft palate
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 Cheeks (Buccal Mucosa)

Similar to lips and soft palate

Nonkeratinized stratified squamous epithelium, lamina propria and submucosa

Submucosa of cheeks contain fat cells along with lobules of minor salivary
glands and muscle fibers 29
 Ventral surface of tongue Floor of mouth

Nonkeratinized stratified squamous Nonkeratinized stratified squamous

epithelium, lamina propria and epithelium, lamina propria and submucosa
submucosa
Epithelium is loosely attached to
Extremely dense muscle fibers lamina propria
interlacing connective tissue fibers 30
in submucosa No muscle
 The Cheeks
• lateral boundary of the vestibule of the oral cavity
 Layers - out side to inside
– Skin
– Superficial fascia containing buccal fat pad
– Buccopharyngeal fascia
– Buccinator muscle
– Mucus membrane (non-keratinized squamous
epithelium): there are small parotid papilla opposite
to the 2nd molar upper teeth where the duct of
parotid gland opens

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Lining Mucosa

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 Cont.…
Masticatory mucosa: It does not stretch and is
attached to bone
– During mastication, it bears chewing forces (covers
gingiva and hard palate)
– It constitutes 25% of the total mucosa

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 The Hard and Soft Palate
• Separate the oral cavity from nasal cavity
(permanently by hard palate; momentarily by soft
palate during swallowing, phonation and fright)
• On nasal side: both palates covered by
pseudostratified ciliated columnar epithelium with
goblet cells; glands are of mixed type (both mucous
and serous)
• On oral side:
– soft palate – non-keratinized stratified squamous
epithelium
– hard palate – keratinized stratified squamous epithelium,
glands are purely mucous
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 Cont.…

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Masticatory Mucosa

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Masticatory Mucosa

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 Gingiva
• Gingiva can be divided into several zones
• Beginning at the gingival margin, the zones
include the free gingiva and interdental papilla,
the free gingival groove (when present),
attached gingiva (highly keratinized and rich in
collagen), and the mucogingival junction
• The alveolar mucosa is the movable tissue rich
in blood vessels that lines the part of the mouth
between the attached gingiva and the lips,
cheeks, and tongue
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 Cont.…

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 Gingiva: Free gingiva
• The zone closest to the tooth crown is the free gingiva,
which is the tissue that is not firmly attached to the
tooth or alveolar bone
• It surrounds each tooth to form a collar of tissue with a
potential space or gingival sulcus hidden between itself
and the tooth
• Free gingiva extends from the gingival margin to the free
gingival groove(visible in about one third of adults) that
separates free gingiva from attached gingiva
• The interdental gingiva or interproximal papilla is that
part of the free gingiva between two adjacent teeth
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 Cont.…

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 Cont.…

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 Clinical consideration
• Sometimes, during the process of eruption of the
mandibular last molar through the mucosa, a flap of
tissue may remain over part of the chewing surface
called an operculum
• This operculum can easily be irritated during chewing
and become infected (called pericoronitis)

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 Gingiva: Attached gingiva
• Attached gingiva is a band or zone of coral pink,
keratinized mucosa that is firmly bound to the
underlying bone
• It extends from the free gingiva junction to the
readily movable alveolar mucosa
• Attached gingiva is most often widest on the
facial aspect of maxillary anterior teeth and on
the lingual aspect of mandibular molars
• It is narrowest on the facial aspect of mandibular
premolars
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 Gingiva: Alveolar mucosa
• The mucogingival junction(line) is a scalloped junction between
attached gingiva and the looser, redder alveolar mucosa
• Alveolar mucosa is dark pink to red due to its increased
blood supply and a thinner epithelium covering
• It is more delicate, non-keratinized, and less firmly
attached to the underlying bone than the attached gingiva
• is found in three places:
– facially next to maxillary attached gingiva
– facially next to the mandibular attached gingiva, and
– lingually next to mandibular attached gingiva
• It is not found lingual to maxillary teeth since the hard palate has
attached keratinized tissue continuous with the lingual gingiva
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 Functions of healthy gingiva
• In health, the gingiva provides support and
protection to the dentition, as well as
esthetics and proper speech (phonetics)

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Clinical: Severe gingival recession

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 Cont.…
Specialized (sensory) mucosa: It is so called as
it bears the taste buds and specialized
papillae (covers dorsum of tongue including
taste buds)
– It constitutes 15% of the total oral mucosa

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 Tongue
 The tongue, which occupies the floor of the mouth is
predominantly a muscle constructed of interlacing
fascicles of skeletal muscle fibers
 During chewing, the tongue grips food and
constantly repositions it between the teeth
 Tongue movements also mix the food with saliva and
form it into a compact mass called a bolus then,
during swallowing, the tongue moves posteriorly to
push the bolus into the pharynx
 In speech, the tongue helps to form some
consonants
 Finally, it houses most of the taste buds
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 Cont.…
 The tongue has both intrinsic and extrinsic muscle fibers
 The intrinsic muscles, which are confined within the tongue
and are not attached to bone, have fibers that run in
several different planes
 These intrinsic muscles change the shape of the tongue,
for example rolling the tongue, but do not change its
position
 The extrinsic muscles extend to the tongue from bones of
the skull and the hyoid bone
 These extrinsic muscles alter the position of the tongue
 They protrude it, retract it, and move it laterally
 The tongue is divided by a median septum of connective
tissue, and both halves contain identical groups of muscles
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 Cont.…

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 Cont.…
 A fold of mucosa on the undersurface of the tongue,
the lingual frenulum secures the tongue to the floor of
the mouth and limits its posterior movements
 The dorsal surface of the tongue is covered with four
major types of peg like projections of the mucosa
(filiform, fungiform, foliate and vallate papillae)
 The terms papillae and taste buds are not synonymous
 foliate, fungiform and vallate papillae contain the taste
buds
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Specialized Mucosa

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 Cont.…
1. Filiform Papillae
 have an elongated conical shape
 are quite numerous and are present over the entire surface of
the tongue
 their epithelium, which does not contain taste buds, is
keratinized stratified squamous epithelium
2. Fungiform Papillae
 resemble mushrooms in that they have a narrow stalk and a
smooth-surfaced, dilated upper part
 these papillae, which contain scattered taste buds on their
upper surfaces, are irregularly interspersed among the filiform
papillae
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 Tongue papillae

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 Cont.…
3. Foliate Papillae
– poorly developed in humans
– They consist of two or more parallel ridges and furrows on the dorsolateral
surface of the tongue
– contain many taste buds
4. Vallate (or circumvallate) papillae
 are the least numerous and largest lingual papillae
 With diameters of 1 - 3 mm, 7 to 12 circular vallate papillae
 form a V-shaped line just before the terminal sulcus
 Ducts from several serous salivary (von Ebner) glands empty into the
deep groove that surrounds each vallate papillae
 These glands also secrete a lipase that prevents the formation of a
hydrophobic film over the taste buds that would hinder their function
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 Taste bud
• are ovoid structures, each containing 50–75 cells, within the
stratified epithelium which contains chemosensory cells in
synaptic contact with the terminals of gustatory cells
• They are not restricted to the papillae, being scattered over
the entire lingual dorsum and sides, epiglottis and lingual
aspect of soft palate
Three types of cells are identified:
• gustatory (taste) cells
– are elongated cells
– turn over with a 7- to 10-day life span
• supportive cells:
– are slender, immature cells
• basal stem cells:
– which divide and give riseStudy
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the other two types 60
 Cont.…
• At the apical ends of the gustatory cells microvilli
project through an opening called the taste pore
• Molecules (tastants) dissolved in saliva contact the
microvilli through the pore and interact with cell
surface taste receptors

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 Cont....
The posterior third of the tongue, which lies in
the oropharynx, not in the mouth, is covered not
with papillae but with the bumpy lingual tonsil

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 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

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 Connective tissue
Lamina Propria
– The lamina propria is the connective tissue supporting
the oral epithelium
– The lamina propria at different regions has different
thickness
– Lamina propria is divided into two parts: (i) superficial
papillary portion (ii) deeper reticular portion
– Papillary portion is associated with epithelial ridges
– The papillary layer consists of finger-like projections of
connective tissue that interlock with similar
epithelium projections
 Cont.…
• The reticular portion is named because of the reticular fibers
• Basement membrane can be distinguished from the connective
tissue of lamina propria as it takes silver stain
• The ridge and papillary arrangement helps to increase the
attachment area
• It also increases the strength of bond between the epithelium
and the lamina propria
• It facilitates exchange between the epithelium and blood vessels
• Free nerve endings are found in the lamina propria and within
the epithelium
 Cont.…
• Reticular portion is associated with a net-like
arrangement of collagen fibers
• Though collagen fibers are also present in the papillary
layer but these are thin as compared to the reticular
layer where the collagen fibers are thick and dense
• In the alveolar mucosa, the papillary arrangement is
missing, but reticular portion is present in every area
• The lamina propria may attach to periosteum of the
alveolar bone
• It may also overlay the submucosa
 Cont.…
• Submucosa is a connective tissue layer that
attaches the lamina propria of the oral mucosa to
the underlying bone or muscle
– Submucosa is of variable thickness and density
– The character of submucosa ascertains whether the
attachment is loose or firm
– Glands, blood vessels, nerves and adipose tissue are
present in the submucosa
 Cont.…
Glandular tissue
– The most important glands of the oral cavity are the salivary
glands
– The principal salivary glands are the parotid (situated buccal to
the upper molars), submandibular and sublingual (located in
the floor of the mouth)
– There are in addition a number of minor salivary glands on the
surface of the tongue, the internal surfaces of the lips and in the
buccal mucosa

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 Major salivary glands
• There are three pairs of major salivary glands:
parotid, sublingual, and submandibular
• They are branched tubuloalveolar glands whose
connective tissue capsule provides septa that
subdivide the glands into lobes and lobules
• Individual acini are also invested by thin
connective tissue elements
• The vascular and neural components of the
glands reach the secretory units via the
connective tissue framework
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 Cont.…
• The secretory portions of salivary glands are composed of
serous and/or mucous secretory cells arranged in acini
(alveoli) or tubules that are couched by myoepithelial cells
• The secretory portions, arranged in tubules and acini, are
composed of three types of cells:
• Serous cells are seromucous cells because they secrete both
proteins and a considerable amount of polysaccharides
• These cells resemble truncated pyramids and have single,
round, basally located nuclei, a well-developed rough
endoplasmic reticulum (RER) and Golgi complex,
numerous basal mitochondria, and abundant apically
situated secretory granules rich in ptyalin (salivary
amylase), which they secrete along with kallikrein,
lactoferrin, and lysozyme
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 Cont.…
• The basal aspects of the lateral cell membranes
form tight junctions with each other
• Apical to the tight junctions, intercellular
canaliculi communicate with the lumen
• The plasmalemma basal to the tight junctions
forms many processes that interdigitate with
those of neighboring cells

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 Cont.…
• Mucous cells are similar in shape to the serous cells
• Their nuclei are also basally located but are flattened instead
of being round
• The organelle population of these cells differs from that of
the serous cells in that mucous secretory cells have fewer
mitochondria, a less extensive RER, and a considerably
greater Golgi apparatus, indicative of the greater
carbohydrate component of their secretory product
• The apical region of the cytoplasm is occupied by abundant
secretory granules
• The intercellular canaliculi and processes of the basal cell
membranes are much less extensive than those of serous
cells
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 Cont.…
Myoepithelial cells (basket cells) share the basal
laminae of the acinar cells
• They have a cell body that houses the nucleus and
several long processes that envelop the secretory
acinus and intercalated ducts
• The cell body houses a small complement of organelles
in addition to the nucleus and makes hemidesmosomal
attachments with the basal lamina
• The cytoplasmic processes, which form desmosomal
contacts with the acinar and duct cells, are rich in actin
and myosin; in electron micrographs these processes
resemble smooth muscle cells
• As the processes of myoepithelial cells contract, they
press on the acinus, facilitating release of the secretory
product into the duct of the gland
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 Saliva production
• Each gland is made up of lobules, which resemble a bunch
of grapes
• The basic secretory units of salivary glands are clusters of
cells called acini
• These acinous epithelial cells consist of two types;
– serous cells which secrete a watery fluid low in mucous and
– mucous cells producing a glycoprotein (mucin) rich secretion
• The serous cells are polyhedral in shape and produce a thin watery
secretion
• The mucous cells are cuboidal and produce a viscous secretion
containing mucin
• When mixed, the serous cells form a cap (demilune) around the
periphery
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Ducts system
• In the intralobular duct system - secretory end
pieces:
– empty into intercalated ducts - lined by cuboidal
epithelial cells
– several of these short ducts join to form striated
ducts
– The columnar cells of striated ducts often show
radial striations extending from the cell bases to
the level of the nuclei
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• The striated ducts of each lobule converge and drain into
ducts located in the connective tissue septa separating
lobules, where they become interlobular, or excretory,
ducts
• They are initially lined with pseudostratified or stratified
cuboidal epithelium,
• more distal parts of the excretory ducts are lined with
stratified columnar epithelium containing a few mucous
cells
• The main duct of each large salivary gland ultimately
empties into the oral cavity and is lined with non-
keratinized stratified squamous epithelium

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 Parotid gland (30%)
• a branched acinar gland with secretory portions composed
exclusively of serous cells surrounding very small lumens
• Serous cells contain secretory granules with abundant -
amylase and proline-rich proteins

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 Submandibular gland (60%)
• is a branched tubuloacinar gland with secretory portions
containing both mucous and serous cells
• The serous cells are the main component of this gland and
are easily distinguished from mucous cells by their rounded
nuclei and basophilic cytoplasm
• Most of the secretory units in this gland are serous acinar,
with about 10% consisting of mucous tubules capped with
serous cells. Such caps are called serous demilunes
• Serous cells of the submandibular gland secrete other
enzymes, including lysozyme, which hydrolyzes the walls in
many types of bacteria
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 Sublingual gland (5%)
– like the submandibular gland
– is a branched tubuloacinar gland
– formed of serous and mucous cells
– mucous cells predominate, with serous cells only
present in demilunes on mucous tubules
– produce is mucus
– cells of the serous demilunes - secrete amylase
and lysozyme

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 Cont.…
• The parotid glands produce a serous secretion, the
submandibular produce a mixture of serous and
mucous and the sublingual glands produce a mainly
mucous secretion
• Secretion is under the control of the autonomic
nervous system which controls both the volume and
type of saliva produced
• Saliva passes through the intercalated ducts, then
the striated ducts and finally passes through the
excretory ducts carrying the saliva to the oral cavity
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 Constituents of saliva
• The composition of saliva is subject to individual
variation
• It consists of 99.5% water and 0.5% dissolved
substances that are made up of:
Salivary proteins: these include:
– Glycoproteins (mucoids): lubricate oral tissues; the
acquired pellicle provides tooth protection
– Enzyme amylase: converts starch to maltose
– Lactoferrins: ferric iron is an essential microbial nutrient;
lactoferrins bind to ferric ions producing an antibacterial
effect
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 Cont.…
– Lysosomes: attack the cell walls of bacteria protecting
the oral cavity from invading pathogens
– Silaloperoxidase (lactoperoxidase): controls established
oral flora by controlling bacterial metabolism
– Histatins: inhibit Candida albicans
– Statherin: inhibits precipitation of calcium phosphates
– Proline-rich proteins: encourages adhesion of selected
bacteria to the tooth surface. They inhibit precipitation
of calcium phosphates
– Salivary immunoglobulins: produce protective
antibodies (IgA)which help to prevent infection
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 Cont.…
Inorganic ions: bicarbonate and phosphate ions
provide a buffering action, which regulates the pH of
the oral cavity
– Calcium and phosphate ions maintain the integrity of teeth
by providing minerals for newly erupted teeth, which helps
with the post eruptive maturation of enamel and prevents
tooth dissolution by enhancing the remineralization of
enamel
– Small amounts of sodium, potassium, chloride, and sulphate
can also be found in saliva
Gases formed: newly formed saliva contains dissolved
oxygen, carbon dioxide and nitrogen
Other additives: urea is formed as a waste product
– Saliva also contains a vast number of microorganisms and
remnants of food substances
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 Cont.…
Muscular tissue
• Muscle develops from mesodermal tissue and is specialized
tissue in that it has both the ability to contract and the ability
to conduct electrical impulses
• Muscles are classified both functionally as either voluntary or
involuntary and structurally as either striated or smooth
• There are therefore three types of muscles:
– Smooth involuntary muscle (e.g. intestinal)
– Striated voluntary muscle (e.g. skeletal)
– Striated involuntary muscle (e.g. cardiac)
• All the oral musculature consists of striated voluntary muscle
• The cells are cylindrical, unbranched and multinucleate
• They contain actin and myosin which are contractile proteins
• The cells are arranged in bundles (fascicles) surrounded by
connective tissue which also serves to anchor the muscle to
bone
3/23/2021 in the form of a tendon/aponeurosis
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 Bone tissue
• Bone is a specialized form of dense connective tissue
• Two types of bone can be distinguished:
• Compact (cortical or lamellar) bone: forms the outer layer of all
bones and consists almost entirely of extracellular substance
(matrix)
– It is built up of numerous vascular canals (Haversian canals)
running along the long axis of the bone around which bone is
deposited by osteoblasts in a series of concentric layers (lamellae)
– As the matrix is deposited, the osteoblasts become trapped in
small hollows (lacunae) and cease to be active in laying down
bone and become osteocytes
– Osteocytes have several thin processes, which extend from the
lacunae into small channels within the bone matrix (canaliculi)
– Compact bone is surrounded by a layer of dense connective
tissue, the periosteum
• Trabecular bone (cancellous or spongy bone): consists of delicate
bars and sheets of bone (trabeculae), which branch and intersect
to3/23/2021
form a sponge like networkStudy
but there are no Haversian systems
hard 88
 Cont.…
• Bone is subject to constant remodeling by osteoblasts
(bone building) and osteoclasts (bone destroying)
• The bone tissue of the maxilla is more vascular and less
dense than that of the mandible

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 The teeth
• Approximately 20% of the surface area of the oral
cavity are constituted by teeth
• Maxillary teeth constitute about 11% and mandibular
teeth constitute about 9% surface area
• The tooth has two parts, crown and root, divided by a
cervical line
• Usually crown is visible in oral cavity and root remain
inside the gums and jaw bone and is not visible
• The part of the tooth visible in oral cavity is the clinical
crown usually called as crown
• In healthy conditions in young adults anatomical crown
i.e. up to only cervical line is visible in oral cavity and
anatomical crown (crown up to cervical line) is equal to
the clinical crown (visible part of crown in oral cavity)
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3/23/2021 Study hard 91
Histology of dental tissues
Dentine
Physical characteristics of dentine
• Dentine is mineralized tissue forming the bulk of
the tooth
• It underlies the enamel in the crown area and is
covered by the cementum in the root area
• Dentine is pale yellow in color and is harder than
bone and cementum but not as hard as enamel

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 Cont.…
Chemical composition of dentine
• 70% inorganic material (by weight) of which the
main inorganic component is hydroxyapatite
[Ca10(PO4)6(OH)2]
• 20% organic material (by weight)
• The main organic component is collagen fibers
embedded in amorphous ground substance
• 10% water (by weight)
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 Cont.…
Structure of dentine
• Dentine consists of many dentinal tubules that run
parallel to each other following a double curved
course and extend from the pulp to the
amelodentinal junction
• Each dentinal tubule contains an odontoblast
process surrounded by intercellular ground
substance composed of fine collagenous fibrils
• The odontoblast cells are a layer of closely arranged
cells on the pulpal surface of the dentine with their
nuclei situated at the basal (pulpal) end of each cell
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 Cont.…
Features of dentine
• The following features of dentine are significant:
– Peritubular dentine: this is highly mineralized dentine found
within each dentinal tubule surrounding the odontoblast
process and can be visualized as similar to ‘furred’ pipes
– Interglobular dentine: these are areas of dentine that
remain unmineralised
– Incremental lines: these are produced due to the rhythmic
pattern of dentinogenesis often referred as contour lines of
Owen. These lines are seen when dentinogenesis is
disrupted (as with amelogenesis)
– Neonatal line: this is only seen in primary teeth and first
permanent molars as a line that marks dentine formation
before and after birth
– Granular layer of Tomes: this is a narrow layer of granular
dentine found in root dentine immediately beneath the
cementum
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 Cont.…
Age changes in dentine
Secondary dentine
• Dentine is a living tissue and with age more dentine continues
to form slowly; this dentine is termed secondary dentine
• Secondary dentine is laid down at the pulpal end of the primary
dentine
• As a result of this the pulp chamber reduces in size with age
Peritubular dentine
• Peritubular dentine tends to increase with age reducing the
diameter of the dentinal tubules

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 Cont.…
Translucent/sclerotic dentine
– The tubules may also become completely obliterated and
when this happens the dentine becomes more translucent;
this is termed translucent or sclerotic dentine
Reparative dentine
– Reparative dentine or irregular secondary dentine is laid
down on the pulpal surface of the dentine in response to an
external stimulus, such as caries, cavity preparation or
excessive wear
– Following a severe stimulus, the odontoblast process may be
destroyed and the contents of the tubule then necrose
leaving the dentinal tubule empty; this is termed a dead
tract
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 Cont.…
• Dentine hypersensitivity
• There are many theories for the mechanism of
dentine sensitivity
• The principal current theories are:
– Innervation theory: the nerve fibres of the pulp pass
into the dentinal tubules
– Odontoblast receptor theory: the odontoblasts act as
a receptor transmitting nerve impulses
– Brännström’s hydrodynamic theory: this suggests
that there is movement of fluid within the dentinal
tubules
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 Cont.…
Enamel
Physical characteristics of enamel
• Enamel is highly mineralized and is the hardest tissue in
the body
• Enamel covers the anatomical crown of the tooth and
varies in thickness
• It is semi-translucent and its color can vary from bluish
white to hues of yellow

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 Cont.…
Chemical composition of enamel
• 96–97% inorganic material (by weight), the
main inorganic component being
hydroxyapatite
• 1% organic material (by weight), the main
organic component being protein
• 2–3% water (by weight)

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 Cont.…
Structure of enamel
• Enamel is made up of millions of enamel prisms or rods, which
run from the amelodentinal junction to the enamel surface
• Each prism is made up of a large number of enamel crystallites
• When viewed under a light microscope each prism resembles
the rounded ‘head’ portion of a keyhole
• The enamel crystallites run parallel to the long axis of the prism
and in the ‘tail’ portion the enamel crystallites are inclined away
from the long axis of the enamel prism
• Enamel is laid down in layers which produce incremental
growth lines
• After each successive layer the ameloblasts retreat so as not to
be trapped within their matrix
• Some growth lines mark daily deposits which are about 4μm
thick;
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these are called cross striations
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 Cont.…

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 Cont.…
• Features of enamel
• The following features of enamel are significant:
• Brown striae of Retzius: these are brown lines indicating variations in
weekly deposits that run obliquely from the amelodentinal junction
towards the enamel surface
– When the striae emerge onto the enamel surface a series of
grooves may be seen; these are termed perikymata grooves
• Hunter–Schreger bands: when viewed under a light microscope,
broad dark and light bands can be seen running obliquely from the
amelodentinal junction to two-thirds of the thickness of the enamel
– They are curved with the convexity of the curve always facing root
wards
• Neonatal line: since this line marks the disruption in amelogenesis
at birth, it can only be seen in primary teeth and first permanent
molars
– It can provide an important forensic landmark
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 Cont.…
• Enamel spindles: this is when the dentinal tubules
extend into the enamel and are found most
frequently beneath cusps
• Lamellae: these are sheets like faults that run
vertically through the entire thickness of the enamel
• Enamel tufts: these are pieces of incomplete
mineralized enamel that resemble tufts of grass
– They extend from the amelodentinal junction and follow
the direction of the enamel prisms
• Amelodentinal junction: the enamel and dentine
meet at the amelodentinal junction; this junction has
a scalloped appearance
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 Cont.…
Cementum
Physical characteristics of cementum
• Cementum is a pale yellow calcified tissue
covering the root dentine
• It is softer than dentine and can easily be
worn away resulting in exposure of the
dentine
• Its thickness varies according to location; it is
thickest towards the apical third of the root
and thinnest cervically
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 Cont.…
• Chemical composition of cementum
• 65% by weight inorganic (mainly hydroxyapatite)
• 23% organic (mainly collagen)
• 2% water

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 Cont.…
• Structure of cementum
• Cementum has a similar structure to bone
• It may be classified by the presence or absence of
cells:
• Acellular cementum: it is the first cementum to
form and is sometimes termed primary
cementum
– It covers the root dentine from the cement-enamel
junction to near the root apex and does not contain
cells
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 Cont.…
• Features of cementum
• The following features of cementum are
significant:
• Cementoenamel junction: this can be variable
• In approximately 60% of teeth, the cementum
overlaps the enamel: in approximately 30% of
teeth the cementum and enamel meet exactly
and in approximately 10% of teeth the
cementum and enamel do not meet thus leaving
an area of dentine exposed
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 Pulp
• Tooth pulp the inner portion of tooth and consists of
connective tissue resembling mesenchyme
• Its main components are the layer of odontoblasts,
many fibroblasts, thin collagen fibrils, and ground
substance
• Pulp is a highly innervated and vascularized tissue
• Blood vessels and myelinated nerve fibers enter the
apical foramen and divide into numerous branches
• Some nerve fibers lose their myelin sheaths and
extend into the dentinal tubules
• Pulp fibers are sensitive to pain
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 Cont.…
Pulp cavity
• It is divided in to the pulp chamber and pulp(root) canals

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 1. Pulp chamber and horns
• The pulp camber is the most occlusal or incisal portion of
the pulp cavity
• There is one pulp cavity in each tooth
• It may be located partly in the crown of anterior teeth, but in
posterior teeth, it is mostly found in the cervical part of the root
• Its walls are the innermost surface of the dentin
• Each pulp chamber has a roof at its incisal or occlusal border often
with projections called pulp horns, and the pulp chambers of
multi-rooted teeth have a floor at the cervical portion with an
opening (orifice) for each root canal

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 Cont.…
• The number of pulp horns found within each
cusped tooth (molars, premolars, and canines) is
normally one horn per functional cusp, and in
young incisors, it is three (one horn in each of
the three facial lobes, which is the same as one
lobe per mamelon)
• An exception is one type of maxillary lateral
incisor (called a peg lateral with an incisal edge
that somewhat resembles one cusp) that has
only one pulp horn
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 Cont.…

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 2. Root canals (Pulp canals)
• Root canals(pulp canals) are the portions of the pulp
cavity located within the root(s) of a tooth
• Root canals connect to the pulp chamber through
canal orifices on the floor of the pulp chamber, and
pulp canals open to the outside of the tooth through
openings called apical foramina most commonly
located at or near the root apex
• The shape and number of root canals in any one root
have been divided into four major anatomic
configurations or types
• The type I configuration has one canal, whereas
types II, III, and IV have either two canals or one
canal that is spilt into two for part of the root
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 Cont.…
• Type I: one canal extends from the pulp chamber to
the apex
• Type II: two separate canals leave the pulp chamber,
but they join short of the apex to form one canal
apically and one apical foramen
• Type III: two separate canals leave the pulp chamber
and remain separate, exiting the root apically as two
separate apical foramina
• Type IV: one canal leaves the pulp chamber but divides
in the apical third of the root into two separate canals
with two separate apical foramina
• Accessory (lateral) canals also occur, located most
commonly in the apical third of the root and, in
maxillary and mandibular molars, are common in the
furcation area
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 Cont.…

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 Cont.…

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 Overview of embryology
• The three primary layers of an embryo are
described as:
– Ectoderm (the outermost layer)This develops into
structures such as the nervous system, the epidermis
and epidermal derivatives and the lining of various
body cavities such as the mouth
– Mesoderm (the middle layer), which forms into many
of the bodily tissues and structures such as bone,
muscle, connective tissue and skin (dermis)
– Endoderm (the innermost layer), which develops to
form the lining of digestive tract and part of the
respiratory system
 Pharyngeal Apparatus
• The head and neck region of four week
human embryo somewhat resemble these
regions of a fish embryo of comparable stage

• This explains the former use of designation

branchial apparatus

• Branchial is derived from the Greek word

branchia or gill
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 Pharyngeal Apparatus

Pharyngeal apparatus consists of:

• Pharyngeal arches
• Pharyngeal pouches
• Pharyngeal grooves/clefts
• Pharyngeal membrane

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 Pharyngeal Arches
• Pharyngeal arches begin to develop early in the
fourth week as neural crest cells migrate into the
head and neck region

• The first pair of pharyngeal arches (primordium of

jaws) appears as a surface elevations lateral to the
developing pharynx

• Soon other arches appear as obliquely disposed,

rounded ridges on each side of the future head and
neck regions
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3/23/2021 Study hard 125
 Pharyngeal Arches
• By the end of the fourth week, four pairs of
pharyngeal arches are visible externally

• the 5th is rudimentary and the tissues of the 6th are

buried in the substance of the future neck region

• The pharyngeal arches are separated from each

other by fissures called pharyngeal grooves/clefts

• They are numbered in craniocaudal sequence

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 Pharyngeal Arches

• The first pharyngeal arch (mandibular arch)

develops maxillary and mandibular
prominences

• The first pair of pharyngeal arches plays a

major role in facial development

• The second pharyngeal arch (hyoid arch)

contributes to the formation of hyoid bone
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3/23/2021 Study hard 128
 Pharyngeal Arch Components
• Each pharyngeal arch consists of a core of
mesenchyme

• Is covered externally by ectoderm and internally by

endoderm

• In the third week the original mesenchyme is

derived from mesoderm

• During the fourth week most of the mesenchyme is

derived from neural crest cells that migrate into the
pharyngeal arches
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 Fate of Pharyngeal Arches
• The pharyngeal arches contribute exclusively to the
formation of the face, nasal cavities, mouth, larynx,
pharynx and neck

• During the fifth week, the second pharyngeal arch

enlarges and overgrows the third and fourth arches,
forming the ectodermal depression called cervical
sinus

• By the end of seventh week the second to fourth

pharyngeal grooves and the cervical sinus have
disappeared, giving theStudy
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a smooth contour 130
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 Fate of Pharyngeal Arches

A typical pharyngeal arch contains:

• A cartilaginous rod that forms the skeleton of the

arch

• A muscular component that differentiates into

muscles in the head and neck

• A nerve that supplies the mucosa and muscles

derived from the arch

• An aortic arch, an artery that arises from the

truncus arteriosus of the primordial heart
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3/23/2021 Study hard 133
Derivatives of Pharyngeal Arch Cartilages

• The dorsal end of first arch cartilage (Meckel

cartilage) ossifies to form malleus and incus

• The middle part of cartilage forms anterior ligament

of malleus and sphenomandibular ligament

• Ventral part of the first arch cartilages form

primordium of the mandible

• The cartilage disappears as mandible develops

around it
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3/23/2021 Study hard 135
 Derivatives of Pharyngeal Arch Cartilages

• The dorsal end of second arch cartilage (Reichert

cartilage) ossifies to form the stapes and styloid
process of the temporal bone

• The ventral end of second arch cartilage ossifies to

form the lesser cornu and superior part of the body
of the hyoid bone

• Its perichondrium forms the stylohyoid ligament

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 Derivatives of Pharyngeal Arch Cartilages

• The third arch cartilage ossifies to form the greater

cornu and the inferior part of the body of the hyoid
bone

• The fourth and sixth arch cartilages fuse to form the

laryngeal cartilages except epiglottis which develops
from hypopharyngeal eminence (3rd and 4th PA)
• The fifth pharyngeal arch is rudimentary and has no
derivatives

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3/23/2021 Study hard 138
 Derivatives of Pharyngeal Arch Muscles
• The musculature of the first pharyngeal arch forms the
muscles of mastication

• The second pharyngeal arch forms the stapedius,

stylohyoid, posterior belly of digastric, auricular and
muscles of facial expression

• The third arch forms the stylopharyngeus

• The fourth arch forms cricothyroid, levator veli palatini

and constrictors of pharynx

• Sixth pharyngeal arch forms the intrinsic muscles of the

larynx
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3/23/2021 Study hard 140
 Derivatives of Pharyngeal Arch Nerves
• Caudal two branches of Trigeminal nerve (maxillary and
mandibular) supply derivatives of the first pharyngeal arch

• The facial, glossopharyngeal and vagus nerves supply the

second, third and caudal (fourth to sixth) arches
respectively

• The fourth arch is supplied by superior laryngeal branch

of vagus nerve

• The sixth arch is supplied by its recurrent laryngeal branch

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3/23/2021 Study hard 142
 Pharyngeal Pouches
• The primordial pharynx, derived from the foregut,
widens cranially where it joins the primordial mouth
or stomodeum

• It narrows caudally where it joins the esophagus

• The endoderm of the pharynx lines the internal

aspects of pharyngeal arches and passes into
balloon like diverticula called pharyngeal pouches
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3/23/2021 Study hard 144
 Pharyngeal Pouches

• The pairs of pouches develop in a craniocaudal

sequence between the arches

• The first pair of pouches lies between the first and

second pharyngeal arches

• There are four well defined pairs of pharyngeal

pouches

• The fifth pair is absent Study

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or hard
rudimentary 145
 Pharyngeal Pouches

• The endoderm of the pouches contacts the

ectoderm of the pharyngeal grooves and
together they form the double layered
pharyngeal membranes that separate the
pharyngeal pouches from the pharyngeal
grooves

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 Derivatives of First Pharyngeal Pouch

• The first pharyngeal pouch expands into an elongate

tubotympanic recess

• The expanded distal part of this recess contacts the

first pharyngeal groove, where it contributes to the
formation of the tympanic membrane (eardrum)

• The cavity of the tubotympanic recess gives rise to

the tympanic cavity and mastoid antrum
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3/23/2021 Study hard 148
 Derivatives of Second Pharyngeal Pouch

• The second pharyngeal pouch is largely obliterated

as the palatine tonsils develop

• Part of the cavity of this pouch remains as the

tonsillar sinus or fossa

• The endoderm of the pouch proliferates and grows

into the underlying mesenchyme

• The central parts of these

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3/23/2021 Study hard 150
 Derivatives of Second Pharyngeal Pouch

• The pouch endoderm forms the surface

epithelium and the lining of the tonsillar
crypts

• At about 20 weeks the mesenchyme around

the crypts differentiates into lymphoid tissue

• These tissues soon organize into the lymphatic

nodules of the palatine tonsil
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Derivatives of Third Pharyngeal Pouch

• The third pharyngeal pouch expands and develops a

solid, dorsal bulbar part and a hollow elongate
ventral part

• Its connection with the pharynx is reduced to a

narrow duct that soon degenerates

• By the sixth week the epithelium of each dorsal

bulbar part begins to differentiate into inferior
parathyroid gland
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Derivatives of Third Pharyngeal Pouch

• The epithelium of the elongate ventral parts of third

pharyngeal pouch proliferates and their cavities obliterate

• These bilateral primordia of thymus come together in the

median plane to form thymus

• It descends into the superior mediastenum

• The bilobed form of thymus remains throughout life

• Discretely encapsulated and each lobe has its own blood

supply, lymphatic drainage and nerve supply
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3/23/2021 Study hard 154
Derivatives of Third Pharyngeal Pouch

• The primordia of thymus and parathyroid

glands lose their connections with the
pharynx and migrate into the neck

• Later the parathyroid glands separate from

the thymus and lie on the dorsal surface of the
thyroid gland

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 Derivatives of Fourth Pharyngeal Pouch

• The fourth pharyngeal pouch also expands into

dorsal bulbar and elongate ventral parts

• Its connection with the pharynx is reduced to a

narrow duct that soon degenerates

• By the sixth week, each dorsal part develops into a

superior parathyroid gland

• It lies on the dorsal surface

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3/23/2021 Study hard 157
 Derivatives of Fourth Pharyngeal Pouch

• The parathyroid glands derived from the third

pouches descend with the thymus and are
carried to a more inferior position than the
parathyroid derived from the fourth pouches

• This explains why the parathyroid glands

derived from the third pair of pouches are
located inferior to those from the fourth
pouches
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 Histogenesis of Parathyroid Gland

• The epithelium of the dorsal parts of the third and fourth

pouches proliferates during the fifth week

• Forms small nodules on the dorsal aspect of each pouch

• Vascular mesenchyme soon grows into these nodules, forming

capillary network

• The chief or principal cells differentiate during the embryonic

period and regulate fetal calcium metabolism

• The oxiphil cells differentiate 5 to 7 years after birth

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 Histogenesis of Parathyroid Gland

• The elongated ventral part of each fourth pouch

develops into ultimopharyngeal body

• Its cells disseminate within the thyroid gland, giving

rise to parafollicular cells

• They are also called “C” cells because they produce

calcitonin that regulate normal calcium level in body
fluids

•3/23/2021
“C” cells differentiate from neural crest cells
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 The Fifth Pharyngeal Pouch

• When this develops, this rudimentary pouch

becomes part of the fourth pharyngeal pouch
and helps to form the ultimopharyngeal body

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 Pharyngeal Grooves

• During the fourth and fifth weeks, head and neck

region of the human embryo exhibit four pharyngeal
grooves or clefts on each side

• These grooves separate the pharyngeal arches

externally

• Only first pair persists as the external acoustic

meatus

• The other grooves normally obliterated with the

cervical sinus as the neck
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develops
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 Pharyngeal Membranes
• Pharyngeal membranes appear in the floor of the
pharyngeal grooves

• These membranes form where the epithelia of the

grooves and pouches approach each other

• The endoderm of the pouches and ectoderm of the

grooves are soon separated by mesenchyme

• Only first pharyngeal membrane becomes the

tympanic membrane, others obliterate
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ARCH NERVE MUSCLES SKELETAL STRUCTURES Ligaments
First Trigeminal Muscles of mastication, Malleus Anterior
(mandib (CN V) Mylohyoid and anterior Incus ligament
ular) belly of digastric of
Tensor tympani malleus
Tensor veli palatine Sphenom
andibular
ligament
Second Facial (CN VII) Muscles of facial Stapes Stylohyoi
(hyoid) expression Styloid process d
Stapedius Lesser cornu of hyoid bone ligament
Stylohyoid Upper part of body of hyoid
Posterior belly of bone
digastric
Glossopharyn Stylopharyngeus Greater cornu of hyoid bone
Third geal (CN IX) Lower part of body of hyoid
bone
Superior and Cricothyroid Thyroid cartilage
recurrent Levator veli palatini Cricoid cartilage
Fourth and laryngeal Constrictors of pharynx Arytenoid cartilage
sixth branch of Intrinsic muscles of larynx Corniculate cartilage
vagus (CN X) Striated muscles of Cuneiform cartilage
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3/23/2021 Study hard 165
 Development of thyroid gland
• The thyroid gland is the first endocrine gland to develop in the
embryo
• It begins to form approximately 24 days after fertilization from a
median endodermal thickening in the floor of the primordial pharynx
• This thickening soon forms a small outpouching-the thyroid
primordium
• As the embryo and tongue grow, the developing thyroid gland
descends in the neck, passing ventral to the developing hyoid bone
and laryngeal cartilages
• For a short time, the thyroid gland is connected to the tongue by a
narrow tube, the thyroglossal duct
• At first the thyroid primordium is hollow, but soon becomes a solid
mass of cells and divides into right and left lobes that are connected
by the isthmus of the thyroid gland, which lies anterior to the
developing second and third tracheal rings
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 Branchial Cysts
• Remnants of parts of the cervical sinus and/or the
second pharyngeal groove may persist and form a
spherical or elongate cyst.
• However, they develop anywhere along the anterior
border of the sternocleidomastoid muscle.
• do not usually become apparent until late childhood or
early adulthood, when they produce a slowly enlarging,
painless swelling in the neck.
First Arch Syndrome
• results in various congenital anomalies of the eyes,
ears, mandible, and palate that together constitute the
first arch syndrome.
• is believed to result from insufficient migration of
neural crest cells.
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An infant with the first arch
syndrome, a pattern of
anomalies resulting from
insufficient migration of neural
crest cells into the first
pharyngeal arch. Note the
deformed auricle, the
preauricular appendage, the
defect in the cheek between the
auricle and the mouth,
hypoplasia of the mandible, and
macrostomia (large mouth).

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A boy showing the swelling
in the neck produced by a
branchial cyst. Branchial
cysts often lie free in the
neck just inferior to the
angle of the mandible, or
they may develop anywhere
along the anterior border of
the sternocleidomastoid
muscle as in this case.

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Treacher Collins syndrome
(mandibulofacial
dysostosis):
• is malar (zygomatic
bones) hypoplasia with
down-slanting palpebral
fissures, defects of the
lower eyelids, deformed
external ears, and
sometimes
abnormalities of the
middle and internal ears
– Pierre Robin syndrome:
• is associated with
hypoplasia of the
mandible, cleft palate,
and defects of the eye
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and ear are present Study hard 170
 DiGeorge Syndrome
• born without a thymus and parathyroid glands and
have defects in their cardiac outflow tracts
• In some cases, ectopic glandular tissue has been found
• anomalies of the mouth (shortened philtrum of lip
[fish-mouth deformity]), low-set notched ears, nasal
clefts, thyroid hypoplasia, and cardiac abnormalities
(defects of the arch of the aorta and heart)
• occurs because the third and fourth pharyngeal
pouches fail to differentiate into the thymus and
parathyroid glands

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 Development of tongue
– Near the end of the 4th week , a median triangular
elevation appears in the floor of the primordial pharynx,
just rostral to the foramen cecum median lingual
swelling (tuberculum impar)
– Soon, two lateral lingual swellings develop on each side
of median tongue bud  This three swellings originate
from the first pharyngeal arch

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 Cont.…
• two oval lateral lingual swellings
– rapidly increase in size, merge with each other,
and overgrow the tuberculum impar
– form the anterior two thirds (oral part) of the
tongue
• Since the mucosa covering the body of tongue
originate from the first pharyngeal arch, sensory
innervation to this area is mandibular division of
trigeminal nerve
• The body of tongue is separated from the posterior
third by a V-shaped terminal sulcus

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 Cont.…
• Formation of the posterior third (pharyngeal part) of the
tongue is indicated in the fetus by two elevations that
develop caudal to the foramen cecum:
• The copula forms by fusion of the ventromedial parts of
the second pair of pharyngeal arches
• The hypopharyngeal eminence develops caudal to the
copula from mesenchyme in the ventromedial parts of the
third and fourth pairs of arches
• As the tongue develops, the copula is gradually overgrown
by the hypopharyngeal eminence and disappears
• As a result, the posterior third of the tongue develops from
the rostral part of the hypopharyngeal eminence
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 Cont.…
• Pharyngeal arch mesenchyme forms the connective
tissue and vasculature of the tongue
• Most of the tongue muscles are derived from myoblasts
that migrate from the occipital myotomes
• The hypoglossal nerve (CN XII) accompanies the
myoblasts during their migration and innervates the
tongue muscles as they develop
• Both the anterior and posterior portions of the tongue
are located within the oral cavity at birth; the posterior
third descends into the oropharynx by 4 years of age

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 Cont.…
• The epiglottis and the extreme posterior part
of tongue are innervated by the superior
laryngeal nerve, reflecting their development
from the 4th pharyngeal arch
• Some of the tongue muscle probably
differentiate in situ, but most are derived
from myoblast originating in occipital somites
• Thus, tongue musculature innervated by the
hypoglossal nerve

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and B, Schematic horizontal sections through the
pharynx showing successive stages in the development
of the tongue during the fourth and fifth weeks. C,
Drawing of the adult tongue showing the pharyngeal
arch derivation of the nerve supply of its mucosa.

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 Lingual Papillae
• Lingual papillae appear toward the end of the 8th week
• The vallate and foliate papillae appear first, close to
terminal branches of the glossopharyngeal nerve (CN IX)
• The fungiform papillae appear later near terminations
of the chorda tympani branch of the facial nerve (CN VII)
• The most common lingual papillae, known as filiform
papillae because of their threadlike shape, develop
during the early fetal period (10-11 weeks)
• They contain afferent nerve endings that are sensitive to
touch

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 Cont.…
• Taste buds develop during weeks 11 to 13 by inductive
interaction between the epithelial cells of the tongue and
invading gustatory nerve cells from the chorda tympani,
glossopharyngeal, and vagus nerves
• Most taste buds form on the dorsal surface of the
tongue, and some develop on the palatoglossal arches,
palate, posterior surface of the epiglottis, and the
posterior wall of the oropharynx
• Fetal facial responses can be induced by bitter-tasting
substances at 26 to 28 weeks, indicating that reflex
pathways between taste buds and facial muscles are
established by this stage
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 Clinical correlation
Ankyloglossia
– The lingual frenulum normally connects the inferior
surface of the tongue to the floor of the mouth
– Sometimes the frenulum is short and extends to the tip
of the tongue
– This interferes with its free protrusion and may make
breast-feeding difficult
– Ankyloglossia (tongue-tie) occurs in approximately one
in 300 North American infants but is usually of no
functional significance
– A short frenulum usually stretches with time, making
surgical correction of the anomaly unnecessary
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 Cont.…

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Development of the salivary glands
• During the 6th and 7th weeks of the embryonic
period, the salivary glands begin as solid
epithelial buds from the primordial oral cavity
• The club-shaped ends of these epithelial buds
grow into the underlying mesenchyme
• The connective tissue in the glands is derived
from neural crest cells
• All parenchymal (secretory) tissue arises by
proliferation of the oral epithelium

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 Cont.…
• The parotid glands are the first to appear (early in the
sixth week)
• They develop from buds that arise from the oral
ectodermal lining near the angles of the stomodeum
• Elongation of the jaws causes lengthening of the parotid
duct, with the gland remaining close to its site of origin
• Later the cords canalize-develop lumina-and become
ducts by approximately 10 weeks
• The rounded ends of the cords differentiate into acini
• Secretions commence at 18 weeks
• The capsule and connective tissue develop from the
surrounding mesenchyme
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 Cont.…
• The submandibular glands appear late in the sixth week
• They develop from endodermal buds in the floor of the
stomodeum
• Solid cellular processes grow posteriorly, lateral to the
developing tongue
• Later they branch and differentiate
• Acini begin to form at 12 weeks and secretory activity
begins at 16 weeks
• Growth of the submandibular glands continues after
birth with the formation of mucous acini
• Lateral to the tongue, a linear groove forms that soon
closes over to form the submandibular duct
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 Cont.…
• The sublingual glands appear in the eighth
week, approximately 2 weeks later than the
other salivary glands
• They develop from multiple endodermal
epithelial buds in the paralingual sulcus
• These buds branch and canalize to form 10 to
12 ducts that open independently into the
floor of the mouth

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 Development of face
• The facial primordia appear early in the fourth week
around the large primordial stomodeum
• Facial development depends on the inductive influence
of the prosencephalic and rhombencephalic organizing
centers
• The prosencephalic organizing center includes
prechordal mesoderm located in the midline rostral to
the notochord and overlying the presumptive
prosencephalic neural plate
• The midbrain-hindbrain boundary is a signaling center
that directs the spatial organization of the caudal
midbrain and the rostral hindbrain structures
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 Cont.…
• The five facial primordia that appear as
prominences around the stomodeum are:
• The single frontonasal prominence
• The paired maxillary prominences
• The paired mandibular prominences

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 Cont.…
• The paired maxillary and mandibular prominences are
derivatives of the first pair of pharyngeal arches
• The prominences are produced mainly by the expansion
of neural crest populations that originate from the
mesencephalic and rostral rhombencephalic neural folds
during the fourth week
• These cells are the major source of connective tissue
components, including cartilage, bone, and ligaments in
the facial and oral regions
• The results of experimental studies in chick and mouse
embryos indicate that myoblasts, originating from
paraxial and prechordal mesoderm, contribute to the
craniofacial
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voluntary muscles
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 Cont.…
• The frontonasal prominence (FNP) surrounds the
ventrolateral part of the forebrain, which gives
rise to the optic vesicles that form the eyes
• The frontal part of the FNP forms the forehead;
the nasal part of the FNP forms the rostral
boundary of the stomodeum and nose
• The paired maxillary prominences form the lateral
boundaries of the stomodeum, and the paired
mandibular prominences constitute the caudal
boundary of the stomodeum
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 Cont.…
• The five facial prominences are active centers of growth in the
underlying mesenchyme
• This embryonic connective tissue is continuous from one
prominence to the other
• Facial development occurs mainly between the fourth and eighth
weeks
• By the end of the embryonic period, the face has an
unquestionably human appearance. Facial proportions develop
during the fetal period
• The lower jaw and lower lip are the first parts of the face to form
• They result from merging of the medial ends of the mandibular
prominences in the median plane

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 Cont.…
• By the end of the fourth week, bilateral oval thickenings of the
surface ectoderm-nasal placodes-the primordia of the nasal
epithelium, have developed on the inferolateral parts of the FNP
• Initially these placodes are convex, but later they are stretched to
produce a flat depression in each placode
• Mesenchyme in the margins of the placodes proliferates,
producing horseshoe-shaped elevations-the medial and lateral
nasal prominences
• As a result, the nasal placodes lie in depressions-the nasal pits
• These pits are the primordia of the anterior nares (nostrils) and
nasal cavities

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 Cont.…
• Proliferation of mesenchyme in the maxillary
prominences causes them to enlarge and
grow medially toward each other and the
nasal prominences
• This proliferation-driven expansion results in
movement of the medial nasal prominences
toward the median plane and each other
• Each lateral nasal prominence is separated
from the maxillary prominence by a cleft
called the nasolacrimal groove
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 Cont.…
• By the end of the fifth week, the primordia of the auricles (external
part of the ears) have begun to develop
• Six auricular hillocks (three mesenchymal swellings on each side)
form around the first pharyngeal groove (three on each side), the
primordia of the auricle, and the external acoustic meatus,
respectively
• Initially the external ears are located in the neck region; however, as
the mandible develops, they are located on the side of the head at
the level of the eyes
• By the end of the sixth week, each maxillary prominence has begun
to merge with the lateral nasal prominence along the line of the
nasolacrimal groove
• This establishes continuity between the side of the nose, formed by
the lateral nasal prominence, and the cheek region formed by the
maxillary prominence
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 Cont.…
• The nasolacrimal duct develops from a rod like thickening of
ectoderm in the floor of the nasolacrimal groove
• This thickening gives rise to a solid epithelial cord that
separates from the ectoderm and sinks into the mesenchyme
• Later, as a result of apoptosis, this epithelial cord canalizes to
form a duct
• The superior end of this duct expands to form the lacrimal sac
• By the late fetal period, the nasolacrimal duct drains into the
inferior meatus in the lateral wall of the nasal cavity. The duct
usually becomes completely patent only after birth

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 Cont.…
• Between the 7th and 10th weeks, the medial nasal
prominences merge with each other and with the maxillary
and lateral nasal prominences
• Merging of these prominences requires disintegration of
their contacting surface epithelia
• This results in intermingling of the underlying mesenchymal
cells
• Merging of the medial nasal and maxillary prominences
results in continuity of the upper jaw and lip and separation
of the nasal pits from the stomodeum
• As the medial nasal prominences merge, they form an
intermaxillary segment, which gives rise philtrum,
premaxillary of maxilla and associated gum, primary palate
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 Development of the palate
The palate develops in two stages:
 The development of a primary palate
 The development of a secondary palate
Palatogenesis begins in the sixth week; however,
development of the palate is not completed until
the 12th week
The critical period of palate development is from
the end of the sixth week until the beginning of the
ninth week

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 Primary palate
• Early in the sixth week, the primary palate-median palatal
process (intermaxillary segment)-begins to develop
– The middle part (philtrum) of the upper lip
– The premaxillary part of the maxilla and its associated gingiva
– The primary palate
• Initially, this segment, formed by merging of the medial
nasal prominences, is a wedge-shaped mass of
mesenchyme between the internal surfaces of the
maxillary prominences of the developing maxillae
• The primary palate forms the anterior/midline aspect of
the maxilla, the premaxillary part of the maxilla
• It represents only a small part of the adult hard palate
(i.e., anterior to the incisive fossa)
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 Cont.…

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 Secondary palate
• The secondary palate is the primordium of the hard and soft parts of
the palate
• The secondary palate begins to develop early in the sixth week from
two mesenchymal projections that extend from the internal aspects
of the maxillary prominences
• Initially these structures-the lateral palatal processes (shelves)-
project inferomedially on each side of the tongue
• As the jaws elongate, they pull the tongue away from its root, and, as
a result, it is brought lower in the mouth. During the seventh and
eighth weeks, the lateral palatal processes assume a horizontal
position above the tongue
• This change in orientation occurs by a flowing process facilitated in
part by the release of hyaluronic acid by the mesenchyme of the
palatal processes
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 Cont.…

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 Clinical correlation

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 Cont.…

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 Development of the jaws
The mandible
 6 weeks of intrauterine life
• The mandible appears as a band of dense fibrous tissue known a
Meckel’s cartilage; this cartilage provides a framework around which
the bone will form
 7 weeks of intrauterine life
• Bone formation commences at the mental foramen area and begins
to spread backwards, forwards and upwards outlining the future
body of the mandible
• As the bone grows backwards, two small secondary cartilages
develop, which eventually form the condyle and coronoid processes
• Anteriorly, the left and right mandibular plate of bone is separated by
cartilage at the mandibular symphysis; these two plates eventually
unite to form a single bone approximately 2 years after birth
• The upward growth of bone increases the height of the mandible
forming the alveolar process which will surround the developing
tooth germ
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 Cont.…
The maxilla
8 weeks of intrauterine life
• Ossification of the maxilla commences at the area of
the developing primary (deciduous) canines; from this
area, bone formation spreads, developing the maxillary
processes: palatal, zygomatic, frontal and alveolar
• Growth of the maxilla occurs by remodeling of bone
and by sutural growth
• The stimulus for sutural bone growth is thought to be
related to the tension produced by the displacement of
bone
• Growth carries the maxilla forwards and downwards as
it increases in size
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 Development of the tooth germ

6-8wks

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 Cont.…

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 Cont.…

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 Cont.…

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 Cont.…

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 Odontogenesis- tooth development
enamel (ameloblasts) develops from the oral
ectoderm
dentine, cementum, pulp, periodontal
membrane originate from the mesenchyme
Mesenchyme derives from the mesoderm and
neural crest cells(ectomesenchyme)

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Development of the dental tissues
Dentine formation – (dentinogenesis)
• Late bell stage the inner enamel epithelium cells
have mapped out the shape of the crown
• The inner enamel epithelium cells induce cells at
the periphery of the dental papilla to form
columnar odontoblast cells (dentine-forming cells)
• Odontoblast cells begin to secrete an unmineralised
dentine matrix
• As more dentine matrix is deposited, the
odontoblast cells retreat in the direction of the pulp
leaving an elongated process known as the
odontoblast process
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 Cont.…
• The dentine matrix formed prior to mineralization is termed
predentine
• A narrow layer of predentine is always present on the surface of
the pulp
• Mineralization of dentine begins when the predentine is
approximately 5μm thick
• Spherical zones of hydroxyapatite called calcospherites are
formed within the dentine matrix
• Mineralization of the dentine matrix starts at random points
and eventually these calcospherites fuse together to form
mineralized dentine
• Dentinal tubules form around each odontoblast process
• The odontoblasts retreat in S-shaped curves towards the dental
papilla
• The first layer of mineralized dentine is called mantle dentine
and the remaining bulk of the mineralized dentine is known as
circumpulpal dentine
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 Cont.…

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 Cont.…
• Enamel formation (amelogenesis)
• Immediately after the first layer of dentine is formed, the inner
enamel epithelium ameloblast cells (enamel forming cells)
• The ameloblast cell is columnar in shape with its base attached to
cells of the stratum intermedium
• At the secretory end of ameloblast cells is a pyramidal extension
called the Tomes’ process
• The enamel matrix is secreted through the Tomes’ process at the
amelodentinal junction

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 Cont.…

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 Cont.…
Enamel maturation
– During maturation from pre-enamel to mature enamel,
the enamel crystallites increase in size and the organic
content is reduced
– On completion of enamel formation the ameloblast cell
loses the Tomes’ process, flattens and becomes the
reduced enamel epithelium
– The reduced enamel epithelium protects the enamel
during eruption and will eventually become the
junctional epithelium

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 Cont.…
• Formation of the root
• Occurs when the crown has
completed
• The internal and external
enamel epithelium grows
downwards at the cervical
loop to form a double
layered epithelial wall –
Hertwig’s root sheath
• The Hertwig’s root sheath
grows apically mapping out
the shape of the root
enclosing the dental papilla
• The dental follicle lies
external to the Hertwig’s
root sheath
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 Cont.…
Cementum formation (cementogenesis)
• The Hertwig’s root sheath induces the formation of
odontoblast cells
• When root dentine has formed, Hertwig’s root sheath
fragments allowing adjacent cells from the dental follicle to
come into contact with the root dentine
• These cells differentiate into cementoblasts (cementum-
forming cells)
• Cementoblasts are cuboidal in shape and form a single layer
on the surface of the root dentine
• The cementoblasts secrete cementum matrix and crystallites
of hydroxyapatite are deposited in this matrix and
mineralization occurs
• During formation, a thin layer of unmineralised cementum is
always
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 Cont.…
• Formation of the periodontal ligament
• Cells within the dental follicle give rise to fibroblasts
that secrete collagen
• Once cementum formation has begun, collagen
fibers within the dental follicle orientate themselves
into bundles, which are perpendicular to the root
surface
• These fibers will form the principal fibers of the
periodontal ligament
• The ends of these fibers become embedded in the
developing cementum and alveolar bone and are
known as Sharpey’s fibers
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 Cont.…
• Tooth eruption
• Tooth eruption is the bodily movement of a tooth from
its development position into its functional position in
the oral cavity
• It can be broken down into two phases; the per-
functional eruptive phase and the functional eruptive
phase

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 Cont.…
• Prefunctional phase
• During the prefunctional phase, crown formation has completed
• As root formation begins the developing tooth begins to erupt
• The overlying alveolar bone is resorbed by osteoclasts and
gradually the tooth moves in an axial direction towards the oral
cavity
• The enamel surface of the tooth is covered by the reduced enamel
epithelium which fuses with the oral epithelium
• The pressure from the tip of the tooth breaks down the oral
epithelium allowing the tooth to emerge into the oral cavity
without any rupturing of blood vessels.
• Once the tooth has emerged, the reduced enamel epithelium is
known as the epithelial attachment.
• Tooth eruption continues until the tooth contacts (occludes with)
the opposing tooth in the opposite jaw
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 Cont.…
• Functional eruptive phase
• The functional eruptive phase continues
throughout life due to functional changes
• The alveolar bone continuously remodels in
response to tooth movement and enamel
wear allowing teeth to maintain contact with
each other and with opposing teeth

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 Cont.…
Mechanisms of tooth eruption
• The eruptive force of tooth eruption is unclear; however,
several theories have been put forward although there is
little evidence to support them. These are:
– Root growth generates a force beneath the tooth, elevating
the tooth towards the oral cavity
– Remodeling and deposition of the bone beneath the
developing tooth pushes the tooth upwards
– Traction of the periodontal fibers exerts an upward pull on
the tooth
– Cellular proliferation at the base of the pulp creates pressure
that pushes the tooth from the dental follicle
– An increase in tissue fluid or blood pressure generates an
eruptive force on the tooth
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 Cont.…
Table 1: Approximate dates of tooth development, eruption
and exfoliation for the primary dentition

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 Cont.…

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 Cont.…
Table 2: Approximate dates of tooth development and
eruption for the permanent dentition

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 Anomalies of Teeth
• Anodentia
• Supernumerary teeth
• Gemination
• Malocclusion
• Precocious eruption of teeth
• Delayed eruption of teeth
• Improper formation of enamel or dentine
• Abnormal location of teeth e.g. in ovary or in
hypophysis cerebri
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 Cont.…

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