development of salivary glands and saliva role in prosthodontics

2. Introduction
Definition
Classification
Embryology
Development
Anatomy
Histology
Salivary gland pathology
Neural regulation

3.  Introduction
 Salivaformation
 Composition
 Propertiesofsaliva
 Prosthodontic
considerations
 Salivaadiagnostictool
 Methodofcollectionof
saliva
 Conclusion
 References

4.  Salivary glands are a group of organs secreting a
watery substance that is of utmost importance
for several physiological functions ranging
from the protection of teeth and surrounding
soft tissues to the lubrication of the oral cavity,
which is crucial for speech and perception of
food taste

5.  Salivary glands are complex networks of
hollow tubes and secretory units that are found
in specific locations of the mouth and although
which are architecturally similar, exhibit
individual specificities according to their
location.
 The three major pairs of salivary
glands are: parotid glands on the insides of
the cheeks. submandibular glands at the floor
of the mouth. sublingual glands under the
tongue.

6. Gland is an organ of secretion made up of
specialized secretory cells derived from the
surface epithelium on which it opens.

7. Based the size, salivary glands are two types
MAJOR SALIVARY GLANDS
 PAROTID GLAND
 SUBLINGUAL GLAND
 SUBMANDIBULAR GLAND
MINOR SALIVARY GLANDS
 LABIAL
 BUCCAL
 PALATINE
 LINGUAL

8. Based on histochemical nature of secretion:
 Serous
 Mucous
 Mixed

9. Based on the site of Secretion
 Exocrine Gland
 Endocrine Gland

10.  The embryologic development of the salivary
glands is the result of a highly orchestrated
complex interaction between two distinct
tissues, the oral epithelium and the underlying
mesenchyme.

11.  All the salivary glands share a common
embryogenesis in that they develop from
growths of oral epithelium into the underlying
mesenchyme.

13. The first sign of salivary gland development
consists of a thickening of the oral epithelium,
known as the placode or prebud stage.the
parotid anlagen appear first, between the
fourth and sixth embryonic weeks, as solid
epithelial placodes in the developing cheeks

14.  The placodes for the submandibular glands
appear later in the sixth embryonic week in
the medial paralingual sulcus. During the
seventh to eighth embryonic weeks, the
sublingual gland anlagen arise from multiple
epithelial placodes, lateral to the
submandibular glands, and finally the minor
salivary glands develop late in the 12th fetal
week

20. Serous
 Thin, watery
 Proteinaceous secretion
 Zymogene granules in
cytoplasm
 Central rounded Nucleus
 Small Lumen
 Indistinct cell bondaries
 Darkly stained
 Enzymatic action
 Parotid Gland
Mucous
 Thick, viscous
 Mucopolysaccharides
 Mucigen droplets
 Nucleus-flat &
peripheral
 Large Lumen
 Distinct cell boundaries
 Ligthly stained
 Protection & lubrication
 Sublingual gland

21. THREE MAJOR SALIVARY GLANDS

33. Labial and buccal glands- Lips and cheek
Glossopalatine- isthmus in glossopalatine fold
Palatine glands- lamina propria of the
posterolateral region of hard palate
submucosa of the soft palate and the
uvula

34. Lingual–
•Anteriorlingual GLANDS OF BLANDIN
AND NUHN -apex of the tongue
•Posterior Lingual (mucous)- lateral and
posterior to the vallate papilla
•Posterior lingual( serous) VON EBNER’S
GLANDS- between the muscle
 fibers of the tongue below the vallate papilla.

39.  Saliva is clear viscous fluid secreted by the
salivary glands in the mouth.
 Saliva contains water, mucin, organic salts and
the digestive enzyme ptyalin.
 It serves to moisten the oral cavity, to aid in the
chewing and swallowing of food and to initiate
the digestion of starch

40.  “Saliva is clear, tasteless, odourless, slightly acidic
viscousfluid, consisting of secretions from the
parotid, sublingual, submandibular salivary glands
of the oral cavity.”

41.  The secretory acinus produces the primary
saliva, which is isotonic with an ionic
composition resembling that of plasma. In the
duct system, the primary saliva is then
modified by selective reabsorption of Na+ and
Cl- (without water) and secretion of K+ and
HCO3-.

42. Saliva formation occurs in two stages
 Primary secretion
 Modification of ionic content

44. Human whole saliva is a complex physiological
secretion which consists of:
 Secretions from major & minor salivary
glands and non salivary origin constitutes
 Gingival crevicular fluid
 Serum & blood cells

45.  Desquamated epithelial cells
 Bacteria & bacterial products
 Viruses & fungi
 Food debris
 Expectorated bronchial secretions

46. Whole saliva can be of 2 types:
 Unstimulated / basal / resting saliva
 Stimulated saliva

47. 99.5%
0.5%0.5%
99.5%

48. SALIVA

50. • Total amount : 1,200 – 1500 ml in 24 hrs. A
large proportion of this volume is secreted at meal
time, when the secretory rate is highest.
• Consistency : slightly cloudy, due to presence
of cells and mucin.
• pH : usually slightly acidic (ph 6.35 – 6.85)
• Specific gravity : 1.002 – 1.012
• Freezing point : 0.07 – 0.340c.

51. submandibular Parotid

52.  Lack of saliva adversely affects the retention
of dentures,
 Increases the possibility of oral infection,
because of loss of lubrication results in
generalised soreness and burning sensation.
 With age change saliva decreases its quantity
and quality.
 Excessive salivation-difficulty for impressions.

53. The various physical factors which affects the
retention are
 Cohesion
 Adhesion
 Surface tension
 Capillary attraction
 Atmospheric pressure

54. COHESION
 Molecular attraction between two similar
surfaces in close contact.
 It occurs in the layer of saliva between the
denture base and mucosa

56.  ADHESION
 Physical molecular attraction of unlike
surfaces in close contact.
 It acts when saliva wets and sticks to the basal
surfaces of dentures

57. SURFACE TENSION
 Resistance to separation by the film of liquid
between two well adapted surfaces.
 It is found in the thin film of saliva between the
denture base and the mucosa of basal seat

58. CAPILLARY ATTRACTION
 Force that causes the surface of liquid to
become elevated or depressed when it is in
contact with a solid.
 On close adaptation of the denture, the space
filled with a thin film of saliva acts like a
capillary tube and helps retain the denture

59. Mira edgerton etal;(1987) saliva :a significant
factor in removable prosthodontic treatment.
reviewed the relationship of saliva to various
aspects of prosthodontic treatment and denture
related disease..

60.  salivary constituents that show a high affinity
for binding with the denture surface may be
responsible for many surface properties of the
denture base, which includes microbial
adherence and plaque formation. salivary IgA
and mucins play an important role

61.  yeast antigens and toxins of denture plaque as
significant factors in the initiation and
maintanance of denture induced stomatitis.
 The quantity and quality of palatine secretions
may be an significant factor for evaluation in
patients with poor denture retention.
 Taste changes are due to some change in the
salivary characteristics.

62. B.W.Darvell and R.K.F.Clark(2000)the physical
mechanism of complete denture retention
stated-
 Denture retention is a dynamic issue dependent
on the control of the interposed fluid viscosity
and film thickness. the most important
concerns being goodbase adaptation and
borderseal

63.  M.diaz-arnold et al(2002)The impact of saliva
on patient care: discussed about the various
causes of salivary gland dysfunction and it’s
management. management included patient
education, consultation with physician for
substitution of offending medication and other
symptomatic relief treatment procedures

64.  Kristina Marton et al (2004)evaluation of unstimulated
flow rates of whole and palatal saliva in healthy
patient’s wearing complete dentures and in patients
with sjogren’s syndrome conducted a study on 24
healthy individuals and two patients with sjogren’s
syndrome to determine whether palatal saliva flow
rates and unstimulated flow rates differed in the two
groups and its influence on new complete dentures.

65. they concluded palatal saliva flow is not
significantly decreased in complete denture
patients with sjogren’s syndrome and their was
no effect on the dentures

67.  Salivary testing is becoming more common as
clinicians have begun to appreciate its
advantages & investigators defined its worth.
Saliva proves to be a reflection of the body.

68.  SYSTEMIC DISEASES-
• HEREDITARY DISEASES- CYSTIC FIBROSIS
• AUTOIMMUNE DISEASES- SJOGREN’S
SYNDROME
• MALIGNANCIES- ADENOCARCINOMA,
BREAST CARCINOMA, OVARIAN
CANCER (MARKERS)

69.  VIRAL INFECTION MARKERS-
• HIV
• OTHER VIRAL DISEASES (due to
immunoglobulins present in saliva)

70.  DRUG MONITORING-
• THERAPEUTIC- Carbamazepine, Diazepam,
Ethosuximide, Lithium, Tolbutamide, etc
• RECREATIONAL- Nicotine, Cocaine, Barbiturates,
 Benzodiapines, Marijuana, etc
 MONITORING OF HORMONE LEVELS

71. Saliva used to identify the onset of certain
diseases.
Biomarkers – small molecules – monitor
disease onset, treatment response and outcome.

73.  Drainingmethod-
 Spitting method-
 Suctionmethod-
 Absorbent method-

74. • Drainingmethod- funnel placed near lip and
patient asked to expectorate saliva into the
funnel to collect in apre-weighed testtube
• Spitting method- saliva allowed to accumulate in
the floor of the mouth and then spat into apre-
weighed tube. For stimulated saliva patient is
asked to chewon paraffin.

75. • Suctionmethod- saliva is aspirated into a pre-
weighed container using a saliva ejector.
• Absorbent method- preweighed swab, cotton
roll, gauzesponge.

76.  Saliva has an important role in patient’s quality of
life. Dental professionals need to be aware of the
problems that arise when there is an
overproduction or underproduction of saliva, and
also a change in its quality.

77.  S.N. Bhaskar. Orban’s Oral histology and
Embryology 11th Edition.
 William G. Shafer., Maynard K. Hine, Barnet
M. Levy. A Text Book of Oral Pathology. 4th
edition, W.B.Saunder’s Company
 Essentials of HumanAnatomy- Head and
Neck, 4th Edition-AKDatta
 Salivary Research Unit, King’s College Londo
n Dental Institute, London, SE1 9RT

78.  Neurographics 2015 July/August; 5(4)167–
177; www.neurographics.org
 Textbookof OralMedicine,A.V.Ghom,Third Edition
 EssentialsOf Medical PhysiologyK.Sembulingam4th Edition