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DH 119 Anatomy of Orofacial structures Exam 1
2011
128
Histology
Professional
09/08/2011

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Term
Why should you as an RDH know the orofacial complex?
Definition
if you know how & when structures develop & form, you can explain it to your patients.
Developmental defects happen in the first few weeks of pregnancy – may need to advise patients against bad habits
Term
• At 3 weeks, the embryo is only __________ in size
Definition
3-4 mm
Term
• Stomodeum=
Definition
primitive mouth
• -Shallow depression below the forehead
• -Forms the oral cavity
Term
Below the stomodeum are
• -These are U-shaped bilateral swellings of tissue
• -Stacked on top of each other
Definition
pharyngeal arches
Term
• Pharyngeal Arch #1
• 2 processes are formed:
Definition
1. mandibular process- forms below the stomodeum
2. maxillary process- forms above the stomodeum
Term
mandibular processes fuse together to form=
maxillary processes fuse together to form=
Definition
mandibular processes fuse together to form=the mandible
maxillary processes fuse together to form= the upper lip, maxilla, zygomatic bones of the cheek & palatal bones
Term
Week 4 ½: on the outer surface of the embryo, rounded areas of thickened tissue are developing =
Definition
placodes
Term
placodes developed at week
Definition
4 1/2
Term
Placodes develop into pits which are
Definition
sensory organs. Eyes, nose & ears come from these: [lens, otic, nasal placodes]
Term
form on the anterior portion of the frontonasal process, just above the stomodeum
• -what do they develop into?
Definition
Nasal Pits. Develop into the nasal cavities
Term
Tissue on the inside (medially) of the nasal pits begins to grow & swell =
Definition
medial nasal processes
Term
medial nasal processes grow towards each other & fuse by week
Definition
week 6
Term
week 4: Maxillary processes start to
Definition
enlarge & grow towards the midline
Term
week 4: Maxillary processes start to
Definition
enlarge & grow towards the midline
Term
[**what 2 processes form the upper lip? at what week?
Definition
Max & medial nasal processes grow towards each other & fuse to form the upper lip. 6th week
Term
• Developmental Problems of the Upper Lip
Definition
• Cleft Lip: unilateral & bilateral
Term
why does cleft lip occur?
Definition
when medial nasal and maxillary processes don't fuse together. can be unilateral on 1 side, or bilateral on both sides.
Term
• Bilateral Cleft Lip
• Definition:
Definition
when medial nasal processes don’t fuse together, or with either max process [both sides] -- Hare lip
Term
in what week does a cleft lip develop?
Definition
6 weeks
Term
what are risk factors for cleft lip?
Definition
a. hereditary: if your family has a history of it, you are more likely to get it
b. environmental: greater risk of birth defects in pregnant women who abuse
Term
**Most common area of occurrence for cleft lip
Definition
between the maxillary lateral incisor & maxillary canine [Anterior teeth may be missing or displaced in this area]
Term
3 problems caused by cleft lip
Definition
1. speech
2. appearance
3. eating/ nourishment
Term
3 treatment options for cleft lip
Definition
1. surgery
2. speech therapy
3. dental treatment, as needed
Term
• Formation of the palate occurs at what week?
Definition
6th
Term
• Formation of the palate: involves what 2 processes
Definition
[same two processes] medial nasal & maxillary processes
Term
• Palate is made up of 2 separate processes:
Definition
primary palate & secondary palate
Term
Medial nasal processes form a V-shaped wedge of tissue that is located in the area of the max central & lateral incisors...called what?
Definition
primary palate
Term
primary palate forms the anterior ________ of the hard palate
Definition
1/3
Term
when does the secondary palate form?
Definition
weeks 7-11
Term
Bilateral maxillary processes: form 2 small ledges of tissue called
Definition
palatal processes or palatal shelves
Term
Palatal shelves start to fuse __________ with the primary plate, continues ________
Definition
anteriorly; backwards

[toward the throat as shelves fuse together]
Term
palatal shelves also fuse with the _______________
Definition
nasal septum, above them
Term
the Secondary palate forms _____________ of the hard palate
Definition
2/3
Term
secondary palate forms 3 things:
Definition
1. posterior 2/3 of hard palate
2. soft palate
3. uvula
Term
result of the fusion of the palatal shelves=
Definition
• Median palatine suture
Term
• Developmental Problems of the Palate?
Definition
cleft palate
Term
• 4 types of cleft palate
Definition
a. unilateral [one side didn’t fuse]
b. bilateral [both sides didn’t fuse]
c. combination cleft lip & palate
d. cleft uvula
Term
• Unilateral Cleft Palate
• Occurs when ?
results in?
Definition
only 1 of the 2 palatal shelves fuses with the nasal septum
• Result: an opening from the oral cavity into one side of the nasal cavity
Term
• Bilateral Cleft Palate
occurs when...?
results in...?
Definition
• Neither palatal shelf fuses with the nasal septum
• Result: openings from oral cavity into both sides of the nasal cavity
Term
• Mildest form of cleft palate
Definition
• Cleft Uvula
Term
When is cleft palate developed:
Definition
week 7-10
Term
cleft palate risk factors:
Definition
• Factors: hereditary & environmental
Term
cleft palate problems? (4)
Definition
• Problems: speech, appearance, eating, oronasal infections
Term
• Cleft Palate Treatment
Definition
• Surgery: to close the space
[should be done around 18 months, no negative memory of surgery]
Obturator: to close the gap [like a partial, blocks nasal cavity]
• Speech therapy
• Dental treatment, as needed
Term
close the gap for a cleft palate
Definition
obturator
Term
• Tongue Development
• Begins
Definition
4th week prenatally
Term
tongue development begins with two...
Definition
U-shaped bars of tissue on the anterior surface of the developing embryo
Term
U-shaped bars of tissue on the anterior surface of the developing embryo
• These are called
Definition
pharyngeal arches
Term
• 4 ½ weeks: tongue begins to develop as a swelling that arises out of
Definition
the back part of the pharyngeal arches
Term
a swelling that arises out of the back part of the pharyngeal arches
• This is called the
Definition
tuberculum impar
Term
the anterior 2/3 of tongue develops from
Definition
tuberculum impar and two lateral swellings
Term
fusion line of the two lateral swellings
Definition
Medial lingual sulcus
Term
?Posterior to anterior swellings form the base of the tongue
Definition
Copula
Term
copula fuses with anterior portion of the tongue at week
Definition
8
Term
when the copula fuses with anterior portion of the tongue it is called
Definition
sulcus terminus
Term
V-shaped border that points backwards, towards the throat
Definition
• Sulcus terminus
Term
• Elevated structures scattered mostly on the dorsal surface of the tongue
Definition
• Papillae
Term
• Circumvallate papillae location, size, number?
Definition
Location: v-shaped row 2/3 of the way back on the tongue (separates the anterior portion from the posterior portion)
Number: 13
Size: large, circular, or mushroom shaped
Term
function of circumvallate papilla is taste, how? (3)
Definition
1. they sit on the tongue with taste buds & grooves or trenches surrounding them
2. Von Ebner’s glands: sit under the papilla
3. these glands open into the trenches & was out old tastes so that we’re ready to accept new ones
Term
small round dots [red dots you can see] (papillae)
Definition
fungiform
Term
how many fungiform papillae? [in comparison with the others]
Definition
fewer than filiform (but more than circumvallate or foliate)
Term
function and number of fungiform
Definition

       Size/shape: small round dots [red dots you can see]

       Number: fewer than filiform (but more than circumvallate or foliate)

       Location: anterior 2/3 of tongue

       Function: taste

       Their taste buds sit on top of the papilla

Term
Problems Associated with Filiform Papilla
Definition
“Black hairy tongue”
“Glossitis”
“Geographic Tongue”
Term
What is “Black hairy tongue”?
What is the result?
Treatment?
Definition
Papilla grow long & normal shedding of the epithelium doesn’t happen,
Result=thick layer of dead cells build up on the dorsal surface.
brush and scrape tongue
Term
what is the cause of glossitis?
what does it look like?
treatment?
Definition
Here the papilla is missing in areas on the dorsal & ventral surfaces of the tongue
• Can look smooth & shiny
• Can occur with certain vitamin deficiencies
• Due to inflammation or infection of the tongue
• Treated by antibiotics antifungals & possibly steroids
Term
what is geographic tongue?
location and appearance?
treatment?
Definition
Location: dorsal & lateral surfaces, mostly
• Appearance: red, pink whitish patches
• Why? Groups of filiform papilla are undergoing changes in the keratinazation of epithelium
• Shows that filiform papilla are sensitive to changes in their environment
• Treatment: none
Term
• Possible Problems Associated with Foliate Papilla
Definition
oral cancer
Term
How many foliate papilla are there?
what do they look like and where are they located?
function?
Definition
Size/shape: vertical, slat-like, with rough ridges
• Location: lateral surface of posterior border
• Number: 4-11
• Function: taste
Term
papilla ranked by numbers...?
Definition
• Most? #1 Filiform
• Next? #2 Fungiform
• Next? #3 Circumvallate 13
• Least? #4 Foliate 4-11
Term
• Small, barrel-shaped bodies
• Have nerve endings that perceive taste
Definition
taste buds
Term
when do taste buds develop?
Definition
11-13th week prenatally
Term
4 locations that taste buds appear
Definition
1. tongue (mostly)
2. soft palate
3. epiglottis
4. pharynx, oropharynx, larynx
Term
5 Taste sensations
Definition
• Bitter, Salty, Sour, Sweet………and
• Umami
Term
umami is japanese for
Definition
savory or deliciousness
Term
• Taste buds across the tongue & mouth contain small groups of cells that enable each bud to detect ________ flavor
Definition
every
Term
Fissured Tongue
• Also known as: _____________
is characterized by what?
Definition
scrotal tongue; folds & fissures on the dorsal surface
Term
fissured tongue is asymptomatic unless
Definition
food lodges in folds: could cause inflammation
Term
• Developmental Disturbance of the Tongue (5)
Definition
Aglossia = NO tongue
• Macroglossia: large tongue
• Microglossia: small tongue
• Bifurcation of tongue: didn’t fuse properly
• Ankyloglossia: tongue-tied
Term
what causes ankyloglossa?
problems?
treatment?
Definition
Due to: short frenum attachment to tip of tongue
• Treatment: may stretch out in time, otherwise surgery plus speech therapy
• Problems: makes speech difficult
Term
Problems associated with tongue piercings:
Definition
recession & bone loss around lingual anteriors. Buccal anteriors: tissue abnormalities.
Term
vertical line dividing arch in ½
Definition
Midline
Term
¼ of an arch, divided by midline
Definition
quadrant
Term
crown
Definition
that portion of the tooth covered by enamel
Term
Root: that portion of the tooth covered by ___________
Definition
cementum
Term
define enamel
Definition
Enamel: hard, mineralized tissue which covers the anatomical crown of a tooth (hardest living body tissue)
Term
: hard tissue that forms the majority of the tooth (surrounds pulp)
Definition
dentin
[--It surrounds the pulp cavity and is covered by enamel in the crown portion, & is covered by cementum in the root]
Term
that portion of the tooth that is inside the dentin of both the crown & the root of the tooth
It contains the living soft tissue in a vital tooth
Definition
Pulp Cavity
Term
2 parts of the pulp cavity:
Definition
1) pulp chamber: that portion found in crown
a) pulp horns: pointed elongations of the pulp chamber (top horns)
Term
pulp canal (location; 2 parts)
Definition
that portion found in the root of the tooth
a) pulp apex: tip of the root (apical)
b) apical foramen: the opening at the apex of the root (where nutrients enter tooth)
Term
CEJ
Definition
Cementoenamel junction-where the enamel of the crown and cementum of the root, meet (neck or cervical area)
Term
DEJ
Definition
Dentinoenamel junction-where the enamel of the crown and the dentin meet
Term
surface towards the gum tissue or neck of tooth
Definition
Cervical/gingival
Term
anterior teeth=chewing surface
Definition
incisal
Term
Coronal
Definition
crown portion: going in the direction of the crown (directional term)
Term
Apical
Definition
root portion: going in the direction of the root (opposite coronal)
Term
a set of natural teeth in the jawbone
Definition
dentition
Term
how many dentitions do humans have? what are they called?
Definition
2
Primary and Permanent
Term
: milk, baby, temporary or deciduous are other names for
Definition
primary dentition
Term
Other names: mature, secondary, adult
Definition
permanent dentition
Term
There are 3 dentition stages
What are they measured* by?
Definition
1)Primary
2)Mixed
3)Permanent
measured by time
Term
Range of primary dentition, when does it begin and end?
Definition
Range: 6 months to 6 years
Begins: with the eruption of the primary mandibular central incisors (o/p)
Ends: with the eruption of the permanent mandibular first molar (19/30)
Term
Range of mixed dentition, when does it begin and end? jawbone growth?
Definition
Range: 6 yrs – 12 yrs
Begins: with the eruption of the permanent mandibular first molar (19/30)
Ends: with the exfoliation of the primary maxillary canine (C/H)
Transitional period: both primary and perm teeth are present “ugly duckling stage”
Jawbone growth: grows the MOST during this period
Term
Permanent Dentition age range, jawbone growth, begins, ends
Definition
Range: 12 yrs +++++
Begins: with the exfoliation of the primary maxillary canine (C/H)
Ends: never, unless totally edentulous
Jawbone growth: shows the least amount during this stage
Term
2 types o tooth numbering systems?
Definition
palmer & universal
Term
Universal numbering system: primary dentition uses letters.... A-?
Palmer uses A-?
Definition
A-T

A-E for each quad
Term
Why is tooth form important? (3)
Definition
a. for function of chewing (mastication)
b. role of speech
c. aesthetics (the way the teeth help shape the face)
Term
function of incisors
Definition
incising; to cut or make an incision; biting
Term
canine function
Definition
pierce; tear; hold; grasp
a) protects jaw joint during lateral (side to side) movement
Term
premolar functions (2)
Definition
Functions: (transitional teeth)
1) assist canines with tearing (1st premolar)
2) assist molars in grinding (2nd premolar)
Term
molar function
Definition
grinding
Term
Anatomical Crown:
Definition
that portion of the tooth that is covered by enamel (fairly consistent over a lifetime)
Term
Clinical Crown:
Definition
the visible portion of the tooth, not covered by the gingiva (this changes over time with inflammation, recession,etc). anything you can see when you look in the mouth.
Term
Anatomical root:
Definition
portion covered by cementum
Term
Clinical root:
Definition
: the portion of the tooth that you CAN’T see (this will change due to recession, etc.)
Term
Triangular shaped space between adjacent teeth, cervical to the contact area (usually filled with tissue in a healthy mouth)
Definition
interproximal spaces
Term
contact areas become more __________ located as you go from anterior teeth to posterior teeth
Definition
cervically
Term
importance of contact areas
Definition
Aids in stabilization of the arch – one missing tooth can affect several surrounding teeth trying to compensate for the huge gap
-Prevents food impaction
Term
Spaces between teeth
Definition
embrasures
Term
how many embrasures does each tooth have? name them
Definition
4

. incisal/occlusal – on surface, opposite interproximal space
Cervical/gingival (same as interproximal)
Facial (which includes labial or buccal)
Lingual (palatal)
Term
Importance of Embrasures
Definition
Anteriorly: impt in aesthetics
Act as spillways for food: self-cleaning mechanism where food just slides off the teeth, unless teeth are malaligned which then there can be issues. Important for embrasures to be perfectly aligned.
Stimulates the tissue
Term
DAQT stands for
Definition
Dentition – primary or permanent
Arch – maxillary or mandibular
Quad – right or left
Tooth type – central incisor, 1st premolar, 3rd molar
Term
Facial & lingual contours of teeth also allow for the __________ of tissue
Definition
stimulation
Term
over contour, under contour affects tooth how?
Definition
Over contour=no stimulation
Under contour=tissue damage
Term
contours direct food....
Definition
off the teeth and away from gingiva at the correct angle
Term
Line angle:
Definition
the surface formed by the junction of 2 tooth surfaces
Term
Point Angles
Definition
The surface formed by the junction of 3 tooth surfaces
Term
The correct order for combining the names of surfaces is:
Definition
A. mesial or distal
B. facial or lingual (which includes buccal, labial or palatal)
C. incisal or occlusal
Term
*on exam: 5. ALWAYS identify whether it is a
Definition
line angle or point angle
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