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THE SALIVARY GLANDS

WHAT IS THIS?

Saliva

complex fluid found lubricating the mucosa and teeth of the oral cavity secreted by the salivary glands
Major

Minor

Types of Saliva

salivary glands, their cells and ducts are greatly responsible for the modification and kind of saliva being secreted It is of three types:
Serous

Saliva Viscous Saliva Mixed Saliva

Serous Saliva

Content:
Amylase

protein polysaccharides

Cell: Serous Cells watery saliva Glands that secrete this type:
Parotid

Gland Von Ebners glands

Viscous Saliva

Content:
Mucins

(glycoproteins) Carbohydrates

Cell: Mucous Cells Thick and viscous Glands that secrete this type:
Sublingual

Gland Minor Salivary Glands (except Von Ebners glands)

Mixed Saliva

simply the combination of the aforementioned types of saliva Able to do a multitude of significant functions Secreted by:
Submandibular

Gland Sublingual Gland

Cells:
Serous

Cells Mucous Cells

Functions of Saliva

Main function: maintaining the well-being of the mouth Other important functions:
Protection

Buffering
Digestion

Action

Facilitation

of Taste Defensive Action against Microbes Ionic Exchange between Tooth Surface

Functions of Saliva
Effect Protection Buffering Action Lubrication, lavage, pellicle formation Regulates pH Active Constituent Glycoprotein Water Phosphate and Bicarbonate

Digestion

Digests starch Digests lipids Bolus formation


Taste bud growth and maturation, dissolves substances to carry to taste buds Antibodies Hostile Environment Posteruptive Maturation of Enamel

Amylase Lingual Lipase


Gustin

Facilitation of Taste

Defensive Action Against Microbes Ionic Exchange Between Tooth Surface

Lysozyme Lactoferrin IgA Calcium Phosphate

MAJOR SALIVARY GLANDS

Major Salivary Glands

Functional Unit
Parenchyma
Stroma

In some books: salivon Three pairs:


Parotid

glands Submandibular glands Sublingual glands

Parotid Glands

In front of the ear behind the ramus of mandible Purely serous Ptyalin and IgA Stensens ductopens opposite the upper second molar

Parotid Glands

Nerve supply: CN V Sympathetic control: superior cervical ganglion Parasympathetic control: CN IX, otic ganglion

Submandibular Glands

Inner aspect of the mandible below the floor of the oral cavity Mixed, 90% serous 10% mucous Secretes lysozymes Whartons duct: opens at each side of the sublingual folds

Submandibular Glands

Serous demilunes

1: intralobular ducts/ striated ducts 2: mucous acinus 3: serous demilunes

Submandibular Glands

Nerve supply: CN V Sympathetic control: superior cervical ganglion Parasympathetic control: CN VII, chorda tympani, submandibular ganglion

Sublingual Glands

Floor of the mouth, below the tongue Mixed, more mucous Ducts of Rivinus Bartholins duct: opens into Whartons duct

Sublingual Glands

Nerve supply: CN V Sympathetic control: superior cervical ganglion Parasympathetic control: CN VII, chorda tympani, submandibular ganglion

MINOR SALIVARY GLANDS

MINOR SALIVARY GLANDS

Over 600 present in the oral cavity Types


Mucous

producing minor salivary glands Serous fluid producing minor salivary glands

Mucous Producing Minor Salivary Glands

Submucosa of the oral mucosa 1-2 mm in diameter Not encapsulated Number of acini connected in a tiny lobule

Serous Fluid Producing Minor Salivary Glands

Aka. Von Ebners Glands Lipid hydrolysis and perception of taste Located around the foliate and circumvallate papillae

Labial Glands

Inner surface of lips Mixed saliva Cells have distinct mucoalbuminous character Terminal portions often form typical demilunes

Minor Buccal Glands

Continuation of the labial glands in the cheek Lie within the vicinity of the opening of the parotid duct Drain into the third molar region Therefore, it is known as molar glands

Glossopalatine Glands

Pure mucous glands Continuation of the lesser sublingual glands (posteriorly) Ascend in the mucosa of the glossopalatine fold

Palatine Glands

Pure mucous glands Occupy the roof of the oral cavity Divided into the glands of the:
Hard

palate Soft palate and uvula

Glands of the Tongue

Anterior lingual gland


Anterior

part- chiefly mucous Posterior part- branching tubules lined with mucous cells and capped with demilunes of serous cells

Posterior lingual glands


Base

of the tongue- purely mucous Glands of the vallate papillae (Von Ebners glands)- purely serous, opens into the trough (depression) of the vallate papillae

Glands of the Tongue

Von Ebners Glands

STRUCTURES OF SALIVARY GLANDS

STRUCTURES OF SALIVARY GLANDS

Parenchyma of glands consists of:


Secretory

Portions Branching Duct Sytem


Lobules

Septae
Capsule

SECRETORY PORTIONS

Serous Cells

Seromucous cells Resemble truncated pyramids Tight junctions Junctional complexes Collectively, serous acini

Apical Cytoplasm of Serous Cells containing secretory granules

Mucous Cells

Adapted for production, storage, and secretion of proteinaceous material Mucins Collectively, mucous acini

Mucous Cells in tubulard secretory end pieces.

Mucous cells showing the serous demilunes.

Myoepithelial Cells

Flattened stellate cells Desmosomes

Myoepithelial Cells

DUCTAL SYSTEM

Intercalated Ducts

Classified as intralobular duct Smallest branch of the system of ducts Prominent in Salivary Glands Frequent in Parotid Gland

Striated Ducts

Formed by union of Intercalated Ducts

Terminal Excretory Ducts

Special eosinophilic cells

Terminal Excretory Ducts

Interlobular excretory duct

SALIVATION REFLEX ACTIVITY


ADDITIONAL INFORMATION

SOURCE: MASTER DENTISTRY VOL. III: ORAL BIOLOGY

Reflex Activity

Resting flow: keeps the mouth and oropharynx moist Food and the prospect of eating: most salivainducing stimuli Whole-mouth saliva contribution when stimulated:
Parotid

gland: 50% Submandibular gland: 30% Sublingual and minor salivary glands: 20%

Reflexes

Gustatory-salivary reflex
Sour>umami>salty>sweet>bitter

Masticatory-salivary reflex
Saliva

flow is directly proportional to masticatory

forces

Olfactory-salivary reflex
No

reflex response from the parotid gland Increase in salivary secretion from the submandibular and sublingual glands

Reflexes

Visual and psychic salivary reflex


Stimuli:

thought and sight of food


of the trigeminal afferent nociceptive

Oral nociceptor-salivary reflex


Stimulation

fibers Increase in parotid saliva secretion

Esophageal-salivary reflex
Waterbrash

phenomenon: sudden filling of the mouth with fluids

DEVELOPMENT OF SALIVARY GLANDS

Development of Salivary Glands

Derived from the oral mucosa Arise in weeks 5-6 of embryonic life

Development of Salivary Glands


PRIMORDIA TIME OF DEVELOPME NT 5th to 6th week EMBRYONIC ORIGIN Ectoderm REGION Parotid gland primordia (anlage) Labiogingival sulcus Hyoid arch

Submandibular 6th week gland primordia Sublingual 7th to 8th week gland primordia Intraoral minor salivary glands 3rd month

Endoderm

Endoderm

Linguogingival sulcus

Development of Salivary Glands


Buds

Epithelial cords

Terminal bulbs

Form clefts

Branches

Repeat process

AGE CHANGES

Age Changes

the aging salivary glands are known to undergo structural changes


The

lobule structure becomes less ordered The acini vary more in size and eventually atrophy Interlobular ducts become more prominent and the percentage of fibroadipose tissue increases

Age Changes

Changes in the salivary glands (submandibular,parotid (less) and minor salivary glands)
Shrinkage

of cells Dilation of ducts Oncocytic transformation Increased adiposity Fibrosis Focal microcalcifications with obstruction Chronic inflammation

CLINICAL CONSIDERATIONS

Mucoceles

CAUSE: trauma to excretory ducts of the minor glands which allows the spillage of mucus into the surrounding connective tissue PHYSIOLOGIC MANIFESTATION: formation of painless, smooth surfaced, bluish lesions TREATMENT: self-limiting (acute) or surgery (chronic)

Mucocele

Ranulas

Type of mucocele CAUSE: blocked sublingual gland ducts PHYSIOLOGIC MANIFESTATION: Unilateral, softtissue lesions, often with a bluish appearance.

Vary in size and may cross the midline of the mouth and cause deviation of the tongue

TREATMENT: self-limiting (acute) surgery (chronic)

Ranula

Sialolithiasis

CAUSE: inactivity of the glands

Metabolic conditions that promote salt precipitation in the glands Predisposing factors: dehydration and poor oral hygiene

PHYSIOLOGIC MANIFESTATION: formation of caliculi TREATMENT: massaged out by a specialist, surgery, antibiotics

Sialolithiasis

Necrotizing Sialometaplasia

UNKNOWN CAUSE

Possible etiologic agent: smoking, trauma, vascular disease

PHYSIOLOGIC MANIFESTATION: uncommon benign lesion and inflammatory condition that affects salivary glands, usually the minor salivary glands TREATMENT: resolves spontaneously, self-limiting

Necrotizing Sialometaplasia

Mumps

Aka. epidemic parotitis (viral) Occurs usually during childhood CAUSE: paramyxovirus that infects the parotid glands PHYSIOLOGIC MANIFESTATION: inflammation of the parotid glands located on either side of the face TREATMENT: warm compress, warm, salt water rinses, antibiotics, surgery, anti-inflammatory medications

Mumps

Salivary Gland Neoplasm

Aka. Salivary gland cancer CAUSE: rapid cell growth of the salivary gland PHYSIOLOGIC MANIFESTATION: present as painless, slow-growing masses TREATMENT: radiation therapy, chemotherapy

Salivary Gland Neoplasms

Irradiation Reaction (Xerostomia)

subjective complaint of dry mouth due to a lack of saliva CAUSE: tumoricidal doses of ionizing radiation, excessive clearance or breathing through the mouth, hyposalivation (decreased saliva production) PHYSIOLOGIC MANIFESTATION: dry oral mucosa TREATMENT: frequent sips of water and frequent mouth care

Xerostomia

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