ORAL EPITHELIUM

DR ANITHA TR
GUIDED BY- Dr NANDINI MANJUNATH
 CONTENTS

1.INTRODUCTION
2.FUNCTION
3.CLASSIFICATION
4.STRUCTURE OF ORAL EPITHELIUM
5.ULTRA STRUCTURE OR ELECTRON MICROSCOPIC STRUCTURE
6.DISEASES OF ORAL MUCOUS MEMBRANE
7.CONCLUSION
8.REFERENCES
INTRODUCTION
“The term moist membrane is
used to describe moist lining of
GIT, nasal passage and other
body cavities that
communicate with exterior.
In oral cavity ,this lining is
referred to as oral mucosa
membrane”
FUNCTIONS OF ORAL MUCOSA
PROTECTION: oral mucosa protects underlying structures
against mechanical trauma that may result from heavy
maticatory stress or from hard food. It aso act as protective
barrier against invasion of microrganisms and various bacterial
products and toxins .

LUBRICATION: the secretion of salivary glands keeps the oral

cavity moist an it prevents the mucosa from dying and craking
thearby ensuring an intact oral epithelium . A moist oral cavity
helps in speech,mastication and swallowing and in perception of
taste.
SENSORY: the oral mucosa is sensetive to touch , pressure, pain,
and temprature.
the sensation of taste is unique sensation,felt only in the anterior
2/3 rd of the dorsum of the tongue

DEFENCE: Oral cavity being a “ideal incubator” harbors a wide

variety of organisms so the integrity of the oral epithelium is an
effective barrier for the entry of the microorganisms.
It also secrets antibodies as a efficient humoral and cell
mediated immunity.
ORBAN AND SICHER CLASSIFICATION

1. MASTICATORY MUCOSA ( gingiva and hard palate)

2. LINING MUCOSA( lip ,cheek , vestibular fornix,alveolar

mucosa,foor of the mouth and soft palate )

3. SPECIALIZED MUCOSA ( dorsum of the tongue and taste

buds)
BASED ON TYPE OF EPITHELIUM COVERING

KERATINIZED MUCOSA:is found in region of hard

palate ,gingiva, vermillion border of the lip and some papillae
of tongue.

NON KERATINIZED MUCOSA: is found in the region of lining

mucosa and certain areas lining the dorsal aspect of tongue .
ORAL MUCOSA

Masticatory mucosa Lining mucosa

Specialized mucosa
MASTICATORY MUCOSA
 Forms 25% of surface area
 Keratinized
Rigid
 Tough
 Tightly bound
 Protective covering components of
Gingiva
Hard palate Alveolar Ridge
LINING MUCOSA

 Forms about 60% surface area

 Nonkeratinized
 loosely bound
 Found over mobile structures like the
Lips
Soft palate
Alveolar mucosa
Floor of the mouth
SPECIALIZED MUCOSA
 It is located on the dorsum of the tongue.
 Non keratinized
 Specialized mucosal structures the lingual papillae and taste
receptors.
 COMPONENT OF ORAL MUCOSA MEMBRANE
 The two main tissue components of the oral
mucosa are a stratified squamous epithelium,
called the oral epithelium, and an underlying
connective tissue layer, called the lamina
propria
 The interface between epithelium and
connective tissue is not flat,rather irregular.
 The epithelial projections are called rete
ridges or epithelial ridges.
 And connective tissue projections are called

connective tissue paillae

 The epithelium and the connective tissue are

seperated by basement membrane.of 1-2

micron thickness.
 ORAL EPITHELIUM
 Oral epithelium is also called as stratified squamous epithelium

 The main function of oral epithelium is to protect the deep structures

while allowing a selective interchange with oral environment.
 Oral epithelium forms the primary barrier between the oral

environment and deeper tissues.

 Oral epithelium is of two types depending upon the functional

requirments
Stratified squamous keratinized epithelium
Stratified squamous non -keratinized epithelium
 The keratinized epithelium can be further devided into ortho

keratinized epithelium and para keratinized epithelium

KERATINIZED EPITHELIUM
 The epithelial cells are called keratinocytes due to the presence of cytokeratins
which are bundled into tonofilaments.
 keratinocyts are attached to each other with the help of intercellular bridges called
desmosomes which are group of cellular junction that are composed of
transmembrane proteins

 The structural integrity of an epithelium is maintained by continuous cell renewal ,in

which cells are produced by mitotic division in the deeper layer which then migrate
to the surface while undergoing maturation. And after reaching the surface shed off.

 After cell division, each daughter cell recycles in the progenitor population or enters
the maturing compartment.

 This divides the cell into two populations : proginator population, ( divide and
provide new cells)
Maturing population ( undergoes maturation / differentiation) also known as
keratinization
 .Turnover time: taken for a cell to divide and pass through the entire epithelium
 52 to 75 days in the skin
 4 to 14 days in the gut
 41 to 57 days in the gingiva
 25 days in the cheek.
 nonkeratinized buccal epithelium turns over faster than keratinized gingival
epithelium.
 So keratinization is nothing but formation of dead cell layer beacuse of
accumulation of keratin protiens.
 This dead cell layer acts as impermeable membrane preventing the entry of
microrganism ,bacteria and virus.
 It also prevents heat loss and water loss from for underlying vital structures and
organs.
 It takes approximately 1 month for a keratinocyte to reach the outer epithelial
surface, where it is shed from the stratum corneum.
 Thus, under normal conditions there is equilibrium between cell renewal and cell loss
so that the epithelium maintains.
 Desquamation is the term given when cells after reaching topmost layer shed off .
 So keratinized oral epithelium is found in the region of hard palate,
gingiva, vermilion border of lip and some papillae of tongue.
 It is inflexible, tough, resistant to abrasion, and tightly bound to the
lamina propria.
 Keratinizing oral epithelium has a keratinocytes arranged in four layers:

 basal layer or stratum basale

 Spinous layer or startum spinousm

 Granular layer or startum granulosum

 Cornifed layer or startum corneum

o These layers take up their name from their morphologic appearance.

STRATUM BASALE
• It is the deepest layer attached to the base
membrane.
 cuboidal to columnar and have
hyperchromatic nucleus.
 this layers is responsible for continous supply
of new keratinocytes and is therefore called
as proliferative or germinative layer(stratum
germinavation).
 They are attached to the basement
membrane by hemidesmosomal junction.
INTERCELLULAR JUNCTIONS
 Inter cellular junctions bind the cells to one
another and allow inter cellular communications.

Three types of junction are :

Desmosomal junction:two hemidesmosomal units

which help in attachment of adjacent cell

Hemidesmosomal junction: provide adesion

between keratinocytes and connective tissue

Gap junction: it present between the two cells which

helps in passage of chemical impulses.
DESMOSOMES
 Desmosomes is made up of two units of
hemidesmosome

 Each hemidesmosome consist of three components:

Attachment plaque : it is made up of proteins like

desmoplakin ,envoplakin,periplakin,plakoglobin,plako
phillins

Extracellular protein: this forms a hook for the

attachment of two cells.
It consist of cadherin family of proteins that are
desmoGLENS, desmoCOLLINS.
Intermediate fillaments: it is made up of keratin
proteins or cytokeratins .
Forces being applied on oral epithelium is distributed
over a wide area with the help of desmosomes and
hemidesmosomes.
CYTOKERATINS
 Cytokeratins (CK) form the cytoskeleton of all epithelial cells, along with
microfilaments and microfilaments.
 It helps in structural integrity of the cell and helps in movement of the

cells within.
 cytoskeleton is made of three major components :

Microtubules - it is the largest portion of the cytoskeleton

Microfilaments-it is the smallest unit of the cytoskeleton
Intermediate fillaments-these are the filaments which lie between the
microfilament and microtubules.
It is made of two units :
type1 ( acidic type ) type 2 ( basic type)
9-23 1-8
CK9,CK10.....CK23
 Both acidic and basic exit together .
 Type 2 cytokeratin have higher molecular weight has compared to
type 1.
 Different layer of epithelium consist of different cytokeratins.
 Any defect in these cytokeratin leads to specific disorder for
example defect in the formation of CK5 leads to epidermolysis
bullosa.
 STRATUM SPINOSUM
o It is seen above the basal layer and composed of
several rows of polyhedral cells.
o Cells are polygonal in shape.
o They contain gylycolipids originating from golgi
complex
o This layer is also called as prickel cell layer because
cells show minute cytoplasmic extension which gives
spiny appearence.
o In stratum spinosum as the cells mature and move
superficially they increase in size and become more
flattened.
o This layer is most active in protein synthesis for
production of cytokeratins
 STRATUM GRANULOSUM
 This layer is composed of few layers of
flattened cells seen immediately above the
statum spinosum.
 This layer is prominent in keratinized
epithelium (absent in non keratinizesd
epithelium.)
 These cells have kerotohyaline granules in
their cytoplasm
 Keratohyaline granules help to form the
matrix of the keratin fibers found in the
superficial layer.
 STRATUM CORNEUM
 This is the most superficial layer found in
keratinized epithelium.
 Cells are flat ,devoid of nuclei and full of
keratin filament surrounded by matrix.
 As the cells reach the coronified layer nucleus
undrgo degeneration.
 If the nucleus is absent in surface layer ,the
pattern of maturation is called
orthokeratinization
 If the pyknotic nucleus s retained in all are
some squamous it is called as
parakeratinization.
ULTRA STRUCTURES OR ELECTRON
MICROSCOPIC STRUCTURE
 BASAL CELLS
• Basal cells are least differentiated cells of the
epithelium
• These cells contain nucleus occupying 1/3 of the cell
with evenly distributed chromatin.
• Basal cells have two populations of cell:
• One group is serrated at basal region and is heavily
packed with tonofilaments, thses cells are adapted for
attachement.
• Second population of cells are the stem cells which
undergo division and provide cells to maturing
compartment.
 PRICKEL CELLS
 It is so called because of pricke/spinous appearance
because cells shrink after histologic preprations.
 There is overall increase in size of the cell and
nucleus as it passes to spinous layer.
 Nucleus has evenly distributed chromatin with 2-3
nucleoli.
 The concentration of tonofilaments increases and
gets arranged in bundels.
 Th size of the desmosome is wider in prickel cell
layer than in basal layer.
 As the cell passes to upper prickel layers the
desmosomes become smaller.
 Cells in the upper part of prickel cell layer show ne
cytoplasmic organelles called odland bodies.
ODLAND BODIES
 These are known as membrane caoating granuals or cytoplasmic
lamellated body
 This is an elongated organelle with parallel lamelle and contains
gylcolipid.
 The size of the odland bodies do not increase but the density increases as
the cell passes to more superficial layer .
 GRANULAR
CELLS
 Cells in this layer are flat but have greater volume than in the spinous
layer.
 cells in this layer posses the lamellate granule which fuse with cell
membrane and release their lipid content into intercellular space
between the granules and the corneal layer forming permiability barrier
 The granular layer is so called because of presence of basophillic
keratohyaline granules that are produced by ribosomes.
 It contains protein fllagrin ,involucrin and loricrin which forms strong
cross-links with tonofilaments.
 This aggrigation of protiens forms a envelope called “cornified cell
envelope” just below the plasma membrane of the granular cell layer
and is effective barrier to chemical solvents.
 The intercellular lipid content produced by the lamellar granules along
CORNEAL LAYER

 Ultrastructurally stratum corneum is

composed of cells resembeling hexoganal
discs called squames.
 Large amount of bundles of keratin
tonofilaments are found to be embadded in
matrix .
 Keratin is the tough insoluble protein which
fills the interior of shrunken cells.
 Cornea cells or squames are shed actively
and this process is called desquamation
 NON KERATINOCYTES

Other cells which are found in the epithelia are

non-keratinocytes/clear cells which include:
 Melanocytes(pigment forming cell)
 Langerhans cells(antigen presenting cell)
 Merkel’s cells(mechanoreceptors)

 melanocytes and langerhans cell together

are called as dentritic cells.
 MELANOCYTES
 The melanocytes are pigment‐synthesizing
cells and are responsible for the melanin
pigmentation.
 They reside in the basal layer.
 Melanocytes are derived from the embryologic
neural crest and migrate into the epithelium.
 Each melanocyte establishes contact with about
30-40 keratinocytes through their dentritic
processes.
 melanocytes vary in number in diffrent regions
and it is not related to number of melanocytes
but to there activity.
LANGERHANS CELL
Langerhans cells have an important role
in the immune reaction as antigen-
presenting cells for lymphocytes.
 They contain g-specific granules

(Birbecks'granules) and have marked

adenosine triphosphatase activity.

 They are found in oral epithelium of

normal gingiva and smaller amount in
the sulcular epithelium; they are probably
absent from the junctional epithelium of
normal gingiva.
MERKEL CELLS

 Are situated in the basal layer of the oral

epithelium
 Merkel cells differ from other

nonkeratinocytes as they are not dentritic.

 Are usually associated with an axon

terminal
 The merkel cell and assosiated axon

terminal form complex that serves as a

touch receptor.
 They are commonly seen in masticatory

mucosa, but are usually absent in lining

mucosa.
NON- KERATINIZED EPITHELIUM
 Non keratinized epithelium differ from keratinizing epithelia
primarily because they do not produce a coronified surface layer.
 The layer of non keratinized epithelium are referred to as
basal ,intermediate and superficial.
 The basal layer of both the types are similar.
 The cells of stratum intermedium are larger than cells of
stratum spinosum.
 There is no stratum granulosum,nor there is stratum corneum.
 Stratum superficiale contains nucleated cells.
 They contain less number of tonofilaments and lack keratohyaline
granules.
 In general non keratinizing oral mucosa have higher rates of mitosis
than keratinizing oral mucosa.
 DISEASES OF ORAL MUCOSA MEMBRANE
 LEUKOPLAKIA: a white patch or plaque in the oral cavity that
comes under precancerous lesion.
 ORAL HAIRY LEUKOPLAKIA: HIV- associated mucosal disorder

 CARCINOMA IN SITU: laterally spreading ,intra epithelial type of

superficial carcinoma.
 ORAL SUBMUCOSA FIBROSIS:predominent precancerous

condition arising in the oral mucosa.

 STOMATITIS NICOTINA:tobacco -related keratosis of the

oralmucosa
 LICHEN PLANUS:chronic mucocutaneous disease ,arises due to

an abnormal immunologcal reaction.

 TRAUMATIC ULCERS:occurs due to -biting,toothbrush trauma or

external irritant.
 CONCLUSION
For a clinicians to treat dental problems knowledge of oral
mucosa membrane is very important .We should check each and
every aspect of oral mucosa while performing clinical
examination .Sometimes the clinical condition which seems to be
normal may take abrupt changes.
REFERENCES
 Kumar GS. Orban’s Oral Histology and Embryology.13th ed.
Elsevier; 2011.
 Nanci A. Tencate’s Oral Histology. Development, Structure

and Function. 8th ed. Elsevier; 2013.

 Maji jose .Essentials of Oral Biology .

OralAntomy,Histology,Physiology & Embryology.