TONGUE AND ITS DEVELOPMENT INTRODUCTION: The tongue is a mobile muscular organ of deglutition; taste and speech which

bulges upward from the floor of the mouth; and its posterior part forms the anterior wall of the oral part of the pharynx. It consists of 2 parts, namely the oral part and the pharyngeal part. The attachments of the tongue are as follows: Hyoid bone Mandible tyloid processes oft palate !haryngeal wall The tongue has " parts:# # $oot # %orsum # &pex # Inferior surface The %orsum part of the tongue is con'ex in shape It is di'ided into # ulcus terminalis # &nterior oral or pre sulcal # !osterior pharyngeal or post The oral and pharyngeal part differ

The oral part of the tongue is located in floor !haryngeal forms the base of the tongue The &pex points towards the incisors ) !osterior ) Margin ) Mucosa reflected laterally ) uperiorly ) %e'oid of papillae The $oot of the tongue is attached to the hyoid bone and mandible and its inferior relations are geniohyoid and mylohyoid. CLASSIFICATION: The tongue can be di'ided into * classes:# +lass I: The tongue lies in the floor of the mouth with the tip forward and slightly below the incisal edges of the mandibular anterior teeth. +lass II: The tongue is flattened and broadened but the tip is in its normal position. +lass III: The tongue is retracted and depressed into the floor of the mouth with the tip facing upward, downward or assimilated into the body of the tongue. & ,ormal Tongue:# Is one where the tip of the tongue rests forward in a position -ust lingual to the mandibular anterior teeth. This is present in ./0 sub-ects. & $etracted Tongue:# +auses the tissues of the sublingual gland to mo'e posterior and inferior to brea1 the seal between the mucous membrane o'erlying the sublingual gland. */0 sub-ects. Development of the tongue: %e'elopment of the tongue starts in the "th month of intrauterine life. The tongue de'elops in relation to the pharyngeal arches in the floor of the de'eloping mouth. 2ach pharyngeal arch arises as a mesodermal thic1ening in the lateral wall of the foregut and that it grows 'entrally to become continuous with the corresponding arch of opposite side. The lingual swellings are partially separated from each other by another swelling that appears in the midline. This median swelling is called the tuberculum 33333. Immediately behind the tubercular 33333, the epithelium proliferates to form a down growth 4thynoglossal duct5 from which the thyroid gland de'elops. The site of this down#growth is subse6uently mar1ed by a depression called the foramen caecum. &nother midline swelling is seen in relation to the medial ends of the second, third and fourth arches. This selling is called hypobranchial eminence which soon shows a subdi'ision into a cranial part related to the second and third arches 4called the copula5 and a candal part related to the "th arch. The candal part forms the epiglottis. The anterior two third of the tongue is formed by fusion of the tuberculum impar, the two lingual swellings. The anterior 27*rd of the tongue is thus deri'ed from the mandibular arch. The posterior (7* of the tongue is formed from the cranial part of the hypobranchial eminence. The second arch mesoderm gets buried below the surface. The third arch mesoderm grows o'er it to fuse with the mesoderm of the first arch. The posterior one third of the tongue is thus from by third arch mesoderm. The posterior most of the tongue is deri'ed from the fourth arch.

The anterior 27*rd of the tongue is supplied by the lingual branch of mandibular ner'e which is the posttraumatic ner'e of the first arch and by the chorda tympani. The posterior (7* of the tongue is supplied by glossopharyngeal ner'e which is the ner'e of the third arch. The posterior most of the tongue is supplied by the superior laryngeal ner'e which is the ner'e of the fourth arch. The muscular of the tongue is deri'ed from occipital myotomes. Development l D!"tu#$ n%e" of the Tongue: (. Microglossia: $are congenital anomaly; it refers to a mall or a rudimentary 2. The term &glossia pertains to the absence of tongue *. Macroglossia presents as a congenital and secondary anomaly. Its treatment is partial excision. ". &n1yloglossia: +omplete, partial. It is seen in tongue tied patients and those with speech difficulty /. +left tongue can be either complete7 bifid !artial cleft is common It presents as a deep groo'e on dorsal surface of the tongue .. 8issured tongue is another 1ind Malformation where small furrows or groo'es are seen on the dorsal surface of the tongue. # Helparin and co#wor1er9s (:./ said increase with age and not a differential diagnosis # 2xtrinsic factor ;. Median rhomboid glossitis is a congenital anomaly 33333333 not retracted before fusion of lateral hal'es 2tiology 333333 8erman et al. %iabeics Treatment not specific 7 antifungal <. =enign migratory glossitis: %ue to geographic condition wandering rash7 erythema migrans It is un1nown in origin and is usually seen as des6uamated area It first appears then regresses then reappears 2ctopic geographic:# >esions are seen in the buccal mucosa, gingi'a, palate, lips, floor of the mouth. It was disco'ered by =ona?y and her associates :. Hairy Tongue is an unusual condition # It is due to the hypertrophy of filliform papillae # Its +olour 'aries from yellowish white7 brown7 blac1 depending on the foods consumed # Increased gagging reflex (@. >ingual 'arices: & dilated tortous 'ein:# sub-ected to increased hydrostatic pressure as it is poorly supported by surrounding tissue # Aleinman concluded that these represent aging # !rior /@yrs premature *

((. >ingual thyroid nodule: & condition in which follicles of thyroid tissue are found in the substances of the tongue; possibly arising from the thyroid 4anlage5 that failed to migrate to its predestined position. May be manifested clinically as a nodular mass in or near the base of the tongue; in 'icinity of foramen ceacum; but not necessarily in midline. P p!ll e: $efers to the pro-ection of mucosa from the dorsum of the tongue. There are " types of papilla namely, 8illiform: 8ungiform: is situated in the most presulcal area of is >arger the tongue More 'allate it is minute; conical; cylindrical in shape Irregularly dorsum Irregular cores of +.T., 1eratini?ed; %eep red color whitish and usually bears one or more taste buds ) &ppear to increase the friction between the tongue and food; facilitating its mo'ement The 8olate papillae: >ying bilaterally forma a series of red; leaf li1e mucosal ridges by sides of the tongue #C sulcus terminalis. it contains numerous taste buds. T "te: DMixture of se'eral sensationsE. Taste pores %orsal Taste !rimary:# Metallic 333333: More than (@@ different taste; combination of primary studies show that the taste buds detects all types of tastes Fther taste sensation:# !ain Ginger Temperature 8la'or !hysiologist ha'e deduced specific receptor for water weet : Frganic substances; saccharides alt : +hlorides of ,a, A; ,H" our : H ion in acids an acidic salts =itter: Frganic compounds; al1aloids Ballate: >arge cylindrical <#(2 in number; (#2mm in si?e its mucosa is narrower at base than apex There are taste buds present

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TASTE &UDS: # +ontain speciali?ed receptors # They are barrel shaped cluster, /@#(/@ fusiform cells present; in oral ca'ity con'erging apically # It is 2 m wide # ;@ m H "@ m Me%h n!"m: ubstances in solution &ttach to microreceptors 2lectrophysiologic changes $eceptor9s stimulated 4near fibers5 ends a message =rain A$no#m l!t!e" of T "te Sen" t!on: &glusia: $efers to loss of taste sensation. $adiation of the oral ca'ity; causes destruction of the taste buds. Hypogeusia: !ertains to the decrease in taste sensation. Increase in threshold for different taste Taste not less completely Taste =lindness: Is rare genetic disorder The ability to recogni?e taste is lost %ysgeusia: %isturbance in taste sensation &!olog!% Con"!'e# t!on: (. while sweet taste !ro'o1es attraction =itter taste pro'ides re-ection Herbi'orous animals bitter plants contain poisonous al1aloids 2. If there is specific need of a nutrient in body, animals often de'elop nac1 for it. e.g. &nimals with ,a deficiency en-oy drin1ing 'ery salty solution, which normally they do not ha'e the nac1 of MUSCLES OF TONGUE: Tongue is di'ided by a median fibrous septum; attached to the body of hyoid bone. It is di'ided into 2 namely, Intrinsic which is wholly within and 2xtrinsic 2xtending outside Gen!oglo""u" !" f n "h pe' mu"%le: # Is triangular in sagital section /

ituated near and parallel to midline up. Gen. tub behind mandibular symphysis Ipwards and bac1wards Inferior fibres To upper anterior surface of hyoid bone # Muscles of opposite side # !osterior by lingual septum # &nterior 'ariably blended %oran and =agget 4(:;25 considered no fibres reach the lingual apex in man or other mammals. A%t!on: # 8orward fraction of the muscle protrudes apex # &cting bilaterally, it depresses the central part of tongue ma1ing it conca'e from side to side # Fn the other hand acting unilaterally it di'erges tongue to other side ()oglo""u": # It is thin 6uadrilateral muscle # It origins from the whole length of greater comu # &nd the front of the body of hyoid bone # Bertically up The fibres upwards and slightly forwards to be inserted between styloglossus and inferior long muscle # 8ibres o'erlap &ction: %epresses the tongue, ma1ing the dorsum con'ex and helps in retracting the protruded tongue. Chon'#oglo""u": !art of hyoglossal # 2 cms long # Medial and base of lesser cornu ad-oining part of hyoid bone St)loglo""u": # hortest and smallest muscle of tongue # It is inserted anterior lateral asp of styloid process # This muscle runs down and forwards # &nd it di'ides tongue longitudinally # &nd blends with inferior long muscle &ction: %raws tongue up and bac1wards during swallowing P l toglo""u": # mall fasciculus muscle # This muscle is narrower at end than middle # It is inserted in the oral surface of palatine aponeurosis about J way along soft palate # ome fibres spread o'er the dorsum of tongue .

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&ction: The palatoglossus ele'ates the root of tongue, approximates the palatoglossal arches and thus closes the oropharyngeal isthmus. INTRINSIC MUSCLES OF TONGUE: +onsists of 2 muscles, namely the up. >ong which forms a thin stratum on the dorsal lingual mucosa near median septum. It ma1es the dorsum conca'e. The second muscle is the inferior long which is a narrow band near inferior lingual surface between genio and hypoglossus. It extends from root to apex The trans'erse muscle passes laterally from the median fibrous septum to submucous fibrous tissue at lingual margin Fn the other hand the 'ertical muscle runs from dorsal to 'entral aspect in the anterior part &ction: &lter the shape by ma1ing the tongue broader. It also flattens the tongue. uperior7 inferior #C tend to shorten; The superior longitudinal muscle turns the apex and sides upwards to ma1e dorsum conca'e whereas the inferior longitudinal muscle pulls the apex down con'ex The trans'erse muscle ma1es the tongue narrow7 elongate and 'ertical muscle flattens7 widens the tongue. Ne#ve Suppl): Muscles Fccipital somites Muscle membrane 2mbryonic pharynx Benous %rainage: # %rain dorsum7 sides # ,ear the greater cornu of hyoid bone it -oins the interior -ugular # =egins at tip runs bac1 near the muscle membrane of tongue9s inferior surface # ,ear anterior border of hyoglossus sublingual 'ein 3333-ugular Appl!e' An tom) of the Tongue: (. In-ury to hypoglossal ner'e produces paralysis of the muscles of the tongue on the side of the lesion. upranuclear lesions of the hypoglossal ner'e produces paralysis; li1e pseudobulbar palsy Tongue is small; stiff mo'es 'ery sluggishly resulting in defecti'e articulation. 2. In unconscious of tongue falls bac1 obstructs airway *. In epileptic patients H commonly bitten ". +& of tongue radiotherapy 2nlarged Tongue are seen in cases of: # %own9s syndrome # &cromegaly # trep. infection # +ancer of tongue ;

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!ellagra !erncious anemia and Hypothyroidism Tongue may broaden in person with no teeth denture

!ain in Tongue are found in incidence where there is, # Glossitis # Geographic tongue # !ost#menopausal women # %iabetic neuropathy Tongue site for oral cancer, mouth ulcer, leu1opla1ia # &nemia # +ancer # %enture irritation # Ilcers # $eferred pain # Hea'y smo1ing # Minor infections # In-ury # &llergic reaction to food # &ntibiotic side effect The +auses of Tongue Tremor can be due to: # ,eurological disorder # F'eracti'e thyroid Khite Tongue can be seen where there is: # >ocal irritation as well as in case of those who are chronic smo1ers and those who consume alcohol. # mo1ing and alcohol Smooth Tongue: &nemia and 'itamin =(2 deficiency are present in patients who comes with a complain of smooth tongue. C "e" *he#e the tongue "ho*" %olo# R nge f#om P!n+ M gent #e " follo*": # 8olic acid and 'itamin =#(2 deficiency # !ellagra # !ernicious anemia # !lummer#Binson syndrome # prue PROST(ODONTIC CONSIDERATION: ,- Spee%h P#o'u%t!on: Tongue has a critical role and impact on speech production; and needs optimal mobility to lift; protrude; flatten form a groo'e and contact ad-acent tissue freely. Tongue can be used for correct positioning of teeth. 2. Mo'ements during border molding: <

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Tongue distorts the lower denture easily =order molding for lingual flange &nterior region Middle # Tongue to touch # !rotrude # Ipper incisors # ideways

!osterior # !rotrude # +lose and apply downward

*. !lacement of teeth in dentures: +orrect teeth positioning Tongue biting a'oided ". =urning tongue is seen in: # 2ndocrine disturbance as well as # $esidual monomer irritation /. ore tongue: # +auses initial discomfort # Tongue thrusting denture Tongue has unfa'orable mo'ements !lace the teeth in neutral ?one area %isplacement of mandibular denture bases by tongue mo'ement during speech. !urpose: To e'aluate denture displacement by denture base during speech. +onclusion: Tongue mo'ements during speech induced only minimal displacement in dentures; additionally; tongue acti'ity was found to be denture stabili?ing rather than displacing in this study. P#o"thet!% M n gement of tot l Glo""e%tom) Defe%t !n E'entulo"u P t!ent": Total glossectomy with surgical reconstruction can result in significant alteration in the mandibular arch. In edentulous patient lingual 'estibules along with mandibular al'eolar ridge can be obliterated; with absence of lower anterior dentition; support of lower lip is lost and traction from surgical closure causes the lower lip to collapse in the oral ca'ity. Ipper +on'entionally +ast poured lip and chee1 >ower oft liner >ight body impression material !rocessed trial bases L.$. recorded B.%.F. is reduced to minimi?e interferences peech wallowing Monoplane occlusal scheme +are to be ta1en to arrange mandibular teeth to gi'e maxillary lip support. Try in is completed with patient appro'al and prosthesis is processed. !erception of roughness of restoration: !urpose H determine a threshold detection 'al'e for surface roughness using tongue. +onclusion: &ny surface which is more than @./ microns can be detected by the tongue.

Inusual occurrence of tongue swelling after G.&.

ub-ects denture can be used to separate the residual ridges during reco'ery period after G.&. This study concluded that before undergoing any procedure under G.&., edentulous patients should ha'e a denture made. & patient who comes with a history of tongue !iercing : # !resents with Isual symptoms; pain, inflammation, difficulty in spea1ing and swallowing # This is considered unethetical for dentist # Ise of lingual frenum in determining the original 'ertical position of mandibular anterior teeth !urpose:# To e'aluate distance between anterior attachment of lingual frenum and incisal edges of mandibular teeth; as preextraction record. +oncluded:# %istance @.(*mm; when frenum is recorded under function Tongue9s motor s1ills and masticatory performance in adult dentates; elderly dentates and complete denture wearers. +oncluded that motor s1ills and masticatory performance decrease in relation to age.

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