Presented by –

Nandana Bose, 1st Yr PGT

Dept. of Prosthodontics and Crown &
Bridge. GNIDSR

Under the Guidance of –

Prof. (Dr.) Jayanta Bhattacharyya,
PRINCIPAL GNIDSR
Prof. (Dr.) Samiran Das
Prof. (Dr.) Soumitra Ghosh
Dr. Sayan Majumdar
Dr. Preeti Goel
 Introduction

 Development

 Anatomy

 Functions

 Clinical examination

 Developmental anomalies involving the tongue

 Prosthetic considerations related to the tongue

 Conclusions

 References
DEFINITION

The tongue is a muscular organ, intimately associated with the function of

taste , speech, mastication & deglutition; it is situated partly in the mouth, and
partly in the pharynx. (Grey’s Anatomy-29th Edition)

It is kept moist by saliva

It is richly supplied by nerves & blood vessels

It also acts as a natural means of cleaning the teeth

Tongue due to its surface characteristics containing numerous depressions,

acts as an niche for bacteria in the oral cavity. Hence, regular cleaning of the
tongue is essential to maintain oral health.
 Development of Tongue
• Development begins at
the 4th week of the IUL

• It develops in the
relation to the
pharyngeal arches in
the floor of the
developing mouth

Laterial view of a developing embryo

showing the formation of pharyngeal
arches
• Pharyngeal arch arises as a
mesodermal thickening in
the lateral wall of the
foregut & it grows ventrally
to become continuous with
the corresponding arch of
the opposite site

• The medial –most parts of

the mandibular arches
proliferate to form two
lingual swellings

• The lingual swellings are

partially separeted from
each other by another
swelling that appears in the
midline called tuberculum
impar
• Immediately behind the
tuberculum impar,the epithelium
proliferates to form a
downgrowth (thyroglossal
duct)from which the thyroid
gland develops.The site of this
downgrowth is subsequently
marked by a depression called
the foramen caecum

• Another midline swelling is seen

in relation to the medial ends of
the 2nd, 3rd arch & 4th arches
called hypobranchial eminence

• Eminence soon subdivided into a

cranial part related to 2nd & 3rd
arches called copula & a caudal
part related to the 4th arch
• The Anterior two-third
of the tongue is formed
by fusion of –
the tuberculum impar
the two lingual swelling
• The Posterior one-third
of the tongue is formed
from the copula
• The caudal part forms
the epiglottis
• The second arch
mesoderm gets buried
below the surface. The
third arch mesoderm
grows over it to fuse with
the mesoderm of the first
arch.

• The muscle of the tongue is

derived from the occipital
myotomes.This explains its nerve
supply by the hypoglossal
nerve,which is the nerve of these
myotomes.
 Anatomy of the Tongue

• Different parts of the tongue –

1. Root
2. Tip
3. Dorsum surface
oral portion
pharyngeal portion
4. Inferior surface
Root of the Tongue
The Tip of the Tongue
• Forms anterior free end

• It should be in rest in position with the tip just

passively touching the lingual surface of the
mandibular teeth.
 Dorsum of the tongue

DIVIDED BY(V shaped Sulcus terminale)

Oral or Anterior or Posterior or

Presulcal part Pharyngeal or
Post sulcal part
• The dorsum surface of the tongue is convex in all the
directions
•Anterior two-third of the tongue is oriented in horizontal
plane
•Posterior one-third of the tongue curves inferiorly &
oriented in verticl plane
 Oral part of the tongue
• Located floor of the mouth
• Lined by stratified squamous
epithelium is mostly
keratinized
• Related the hard & soft
palate
• It supplied by the
mandibular nerve through
its lingual branches
• covered by hundreds of
papillae
Papillae of the tongue
 Taste Buds
•Unique sense organ that contain the chemical sense
for taste. Microscopically visible barrel-shaped
intraepithelial organ

•Usually associated with the papillae of the tongue.

Also seen in soft palate, epiglottis, larynx & pharynx

•Each taste bud has 10-14 neuroepithelial cells,the

receptor of taste stimuli. They are modified columnar
elongated cell, superficial part of these cells is
provided with short hairs i.e microvilli

•The base of the taste cells is surrounded by sensory

nerve fibres, carry the impulses of taste sensation to
the brain.
Pharyngeal part of the tongue
• Lies posterior to the palatoglassal arch
• Forms anterior wall of the oropharynx
• Devoid of any papillae
• The mucous membrane has many lymphoid follicles that
collectively called lingual tonsil
• Glands of Weber- They are pure mucous secreting ,lie along
the lateral border of the tongue. These opens into the crypts
of the lingual tonsils on the pharyngeal part of the tongue
• Supplied by the glossopharyngeal nerve
• The posterior part of the tongue is connected to the
epiglottis by three folds of mucous membrane. These are
the median glossoepiglottic fold and the right and left lateral
glossoepiglottic folds.
 Inferior surface of the Tongue
• Covered by smooth mucous membrane
• The thin strip of tissue that runs vertically from the floor of the mouth to the undersurface of the tongue is called
the lingual frenulum.
• It tends to limit the movement of the tongue
• On either side of the frenulum there is a prominence produced by deep lingual veins & more laterally there is a
fold called plica fimbriata
(they are normal
residual tissue not completely reabsorbed by
the body during the development & growth
Of the tongue)
• Anterior lingual glands are deeply placed near the tip of the tongue on each side of the lingual
frenum,mainly seromucous in nature

• They are found on the under surface of the apex of the tongue
( glands of Blandin Nuhn)
 Muscles of the Tongue
• Tongue divided into a left & right half by a
median saggital septum composed of
connective tissue.This means all the muscles
of the tongue are paired
• Except palatoglossus,which is innervated by
the vagas nerve,all muscles of the tongue are
innervated by the hypoglossal nerve
 Intrinsic Muscle of the Tongue
• Four paired intrinsic
muscles originate &
inserted within the
tongue
• These muscle alter the
shape of the tongue
• It is not attached to any
bone
• Innervated by
hypoglossal nerve
Intrinsic Muscle of the Tongue
Extrinsic Muscle of the tongue
Genioglossus Muscle
Hyoglossus Muscle
Styloglossus Muscle Palatoglossus Muscle
 Movements
• Protrusion: Genioglossus on both side acting
together
• Retraction: Styloglossus & Hypoglossus on
both sides acting together
• Depression: Hyoglossus & Genioglossus on
both sides acting together
• Elevation: Styloglossus & Palatoglossus on
both side acting together
Vascular supply of the Tongue
Venous Drainage of the Tongue
Innervation of the tongue
Lymphatic drainage of the Tongue
 Function of the Tongue
•Speech

•Mastication

•Taste sensation

•Deglutition

•Jaw development

•Thermal regulation

•Maintainance of oral hygiene

Scarlet Fever : Strawberry tongue
Whooping cough : Traumatic ulceration on lingual
frenum
Iron deficiency anemia : Atrophic glossitis
Plasmacytoma: Tumor manifestation in tongue
Methemoglobinemia: Bluish appearance of tongue
Addison’s disease: Bronze discoloration of tongue
(1949)
House’s Classification on Tongue Size:
1. Class I : Tongue normal in size, development & function aided by the
presence of sufficient number of the teeth.

2. Class II : Prolonged absence of teeth leading to change in the form &

function of the tongue

3. Class III : Excessively large tongue. Absence of teeth for an extend

period of time, leading to abnormal development of the size of the
tongue. Insufficient denture may also lead to development of Class III
tongue
 Developmental anomalies of the tongue

MACROGLOSSIA MICROGLOSSIA BIFID TONGUE BLACK HAIRY

TONGUE

LINGUAL THYROID GEOGRAPHIC FISSURED

ANKYLOGLOSSIA
NODULE TONGUE TONGUE
Tongue is strongly associated with retention, stability as well as functioning (mastication and
speech) of the prosthesis. Necessary changes are to be made in the prosthesis according to
different clinical situations.

Macroglossia:
•Proper designing of the lingual flange at the wax up stage helps to increase the stability of
mandibular denture
• This can be achieved by adding very little wax, behind the incisors region while behind the
premolars, a flat or slightly concave surface should be established.
• In the molar and retromolar region, the polished surface is designed to be slightly concave
•Narrow posterior teeth should be selected.

Microglossia:
- Thick lingual flange is to be made in the mandibular denture to obtain the lingual seal, along
with placement of wider posterior teeth.

Ankyloglossia:
- Surgical excision of the tongue tie is to be done. The lower denture is to be fabricated before
the surgical phase. Following the surgery, the lower denture acts as a barrier to prevent
possibility of any reattachment of the frenum.
To achieve adequate retention in the mandibular denture, the lingual surface has to
be designed in such a way that, the denture maintains contact seal with the tongue
and the floor of the mouth during rest and function.
Sublingual crescent area or Anterior lingual
sulcus:

 It is moulded by asking the patient to

protrude the tongue so that the posterior fibre
of the genioglossus muscle gets activated.
Anterior region of the floor of the mouth is
raised to determine the length of the lingual
flange in the anterior lingual sulcus.

 Done by sking the patient to retract the

tongue, for activation of fiber of the
genioglossus muscle, thus the width of the
border of the anterior lingual Sulcus can be
determined.
 CONCLUSION

The knowledge of anatomy,physiology, function of the

tongue & also proper examination of the tongue is very
essential to reach the optimal prosthetic success because
tongue play most significant role in lower denture stability
& retention
 References
•Iderbir Singh,Human Embriology(10th edition)
•Grey’s Anatomy for student(2nd edition)
•Oral & maxxilofacial
pathology,Naville,Damm,Allen,Bouquot(2nd edition)
•Orban’s Oral Histology & Embriology(12th edition)
•Anatomy of the Lingual Vestibule and its Influence on Denture
Borders
Gandage Dhananjay S1*, Abu Siddiqui2, Gangadhar SA1 and
Lagdive SB

• Annals
of Dental Research (2012) Vol 2 (1): 44-51 ©
Mind Reader Publications